Manager Quality Assurance

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Job Summary:

The Revenue Cycle Manager of Quality Assurance is responsible for overseeing the quality and effectiveness of the revenue cycle processes, ensuring compliance with industry standards and regulations, and driving continuous improvement initiatives. This role ensures that various stages of the revenue cycle meet organizational standards for accuracy, efficiency, and quality, contributing to the overall success of the revenue cycle and enhancing patient satisfaction.The Revenue Cycle Manager of Quality Assurance is responsible for overseeing the quality and effectiveness of the revenue cycle processes, ensuring compliance with industry standards and regulations, and driving continuous improvement initiatives. This role ensures that various stages of the revenue cycle meet organizational standards for accuracy, efficiency, and quality, contributing to the overall success of the revenue cycle and enhancing patient satisfaction.

Core Responsibilities and Essential Functions:

General Leadership - A. Provides direct management and oversees the work activities of the revenue cycle centralized support services quality team, ensuring alignment with organizational goals. B. Collaborates closely with other departments to ensure a cohesive approach to quality within the revenue cycle, fostering interdepartmental communication and teamwork. C. Monitors and validates the quality of reporting, ensuring that information is technically sound, consistent, clear, and professionally presented. D. Acts as a liaison between the revenue cycle operations team, revenue cycle informatics, and IT to optimize the use of technology and automation, enhancing efficiency and accuracy. E. Promotes a culture of quality and accountability within the revenue cycle team, encouraging continuous improvement and adherence to best practices. F. Investigates operational performance to identify areas for improvement and support ongoing operational excellence. Quality Assurance and Compliance A. Develops, implements, and monitors quality assurance standards and metrics in collaboration with leadership, ensuring they meet the needs of revenue cycle leadership and drive quality improvements. B. Ensures compliance with healthcare regulations, including HIPAA, CMS guidelines, and other state/federal requirements, maintaining the highest standards of regulatory adherence. C. Conducts regular audits to verify compliance and quality in revenue cycle functions, identifying areas for improvement. D. Creates and recommends corrective action plans to address areas where quality and compliance standards are not met, ensuring continuous improvement. Data Analysis and Reporting 25 A. Collects and analyzes data to monitor revenue cycle performance, identify trends, and detect potential issues, providing actionable insights. B. Prepares regular reports on quality metrics, audit results, and improvement initiatives for senior leadership, ensuring transparency and informed decision-making. C . Monitors and reports on key performance indicators (KPIs) such as claim denials, reimbursement rates, and collection times, driving performance improvements. Process Improvement A. Identifies areas for improvement within the revenue cycle and collaborates with cross-functional teams to implement effective changes, enhancing overall efficiency. B. Standardizes processes across the revenue cycle to streamline operations, reduce errors, and improve efficiency, ensuring consistency and reliability. C. Leads or participates in Lean Six Sigma or other process improvement projects to optimize workflows, driving continuous improvement and operational excellence. Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

• Associates Other

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

• CRCR - Certified Revenue Cycle Rep within 180 Days

Additional License(s) and Certification(s):

Required Minimum Experience:

Minimum 5 years Healthcare management or related experience Required or Minimum 10 years related experience will be considered in lieu of degree Required

Required Minimum Skills:

* Strong knowledge of revenue cycle processes, including billing, coding, collections, and regulatory compliance. High Experience with quality improvement methodologies (e.g., Lean, Six Sigma) and audit processes. Medium Prefer experience in Epic Medium Excellent analytical, organizational, and communication skills. High .Ability to work independently and as part of a team, with a focus on results High Personal desire for continuous knowledge and skill growth and development. High Initiative-taking and well-organized with strong time management skills. High Strong interpersonal communication skills and the ability to work well with all levels of the organization. High Demonstrate and support Wellstar Team Member and Leader Behavior Standards. High

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