Division Director of Denial Prevention

Description

This position is incentive eligible.

Managers thrive with us! HCA Healthcare is one of the nation’s leading providers of healthcare services, comprising of over 180 hospitals and about 2,000 sites of care in 21 states and the United Kingdom. We are looking for a Division Director of Denial Prevention for our HCA Healthcare team where excellence creates excellence.

HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free Air Med medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
• 401(k) Plan with a 100% match on 3% to 9% of pay based on years of service
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more
• Consumer discounts through Abenity and Consumer Discounts
• Retirement readiness, rollover assistance services and preferred banking partnerships
• Education assistance (tuition, student loan, certification support, dependent scholarships)
• Colleague recognition program
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note:
Eligibility for benefits may vary by location.

HCA Healthcare has expanded our influence across the healthcare industry by investing 3.5 billion in capital improvements in recent years. Do you want to be an influencer in healthcare?
Apply for our Division Director of Denial Prevention role today!

We are seeking a Division Director of Denial Prevention. As our new Director, you will be responsible providing direction & oversight of concurrent denial prevention within the West Florida Division. Maintains a current working knowledge of non-governmental and governmental payers and the contracted language. Knowledge of payer trends and analysis of denials with a focus on prevention of denials within the acute setting.

We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. Take the next step in your career.

In this role you will be responsible for:

• Assist with the identification of strategies for prevention and initiate processes for denial avoidance.
• Monitors and provides detailed analysis of trends in the non-governmental & governmental sector.
• Assist hospitals with root cause analysis of denials.
• Directs hospitals in developing and implementing action plans as needed.
• Identifies education opportunities across the division hospitals and provides education communication assistance to the SSC (Shared Services Center) including appeals, CIV, NOA, and hospital PADsas needed.
• Provides for weekly monitoring and dashboard development and review.
• Interacts with payers as required or as needed to resolve issues or opportunities of concern.
• Interacts with physicians, CUR leadership, hospital leadership, PC&A, Corporate leadership to implement action plans and develop solutions.
• Must be results oriented.
• Have a working knowledge of URAC Guidelines and credentialing and is knowledgeable in Inter Qual Criteria and the revenue cycle.

• Bachelor’s degree required
• Registered Nurse or Certified Professional Coder (CPC) required
• Denial/Appeal management experience required
• Minimum of 2 years manager experience required
• Analytical skill set necessary
• Excellent communication skills and customer service oriented

HCA West Florida is a network of hospitals, surgery centers, physician practices, medical education and training programs. We have a complete continuum of specialized health services that meet the healthcare needs of residents and businesses. In 2020, HCA West Florida had more than 1.5 million patient encounters. We provided an economic impact of more than 2.4 billion. With its founding in 1968, HCA Healthcare created a new model for healthcare in the United States.

HCA Healthcare has used combined resources to enhance hospitals, deliver patient-focused care and improve the practice of medicine.

HCA Healthcare has been…