University of Utah

Department 00848 - Pediatric Administration Job Summary

Job Summary

The Pediatric Outpatient Reception and Prior Authorization Manager is a member of the ambulatory operations team responsible for pediatric sub-specialty clinical services and reports to the Associate Director of Ambulatory Care. Under minimal supervision, the position is responsible for managing the front desk and the prior authorization staff. This position is responsible for planning, organizing, directing and controlling all aspects of the assigned department’s internal and external customer service, staffing and financial management operations. Acts as a catalyst between the department and its customers and staff to ensure continuity and quality of service and care. Promotes sound operational practices using a variety of communication strategies, process efficiencies, training programs, and data-based metrics. Conducts routine meetings with staff and recommends changes to the Associate Director when necessary. Assists in implementation of new processes.

Responsibilities include managing over 20 employees and ensuring compliance with quality healthcare practices and department and facility policies and procedures. The Pediatric Outpatient Reception and Prior Authorization Manager plays a vital role in staff development, empowering front desk teams to deliver exceptional customer service and guiding prior authorization staff in working with health insurance companies to ensure patients have access to healthcare services.

This position is located at the Eccles Primary Children’s Outpatient building in Salt Lake City. The ambulatory group in the Department consists of 14 pediatric subspecialty divisions and service lines that practice primarily at Eccles Primary Children’s Outpatient Services building (PCOS), Miller Primary Children’s Outpatient Services Building in Lehi, Primary Children’s Hospital (PCH) Riverton, PCH Layton, and some satellite clinics. The pediatric ambulatory clinics at PCH operate in clinic space that is leased from PCH and used in conjunction with PCH and other University and community pediatric providers.

The Department of Pediatrics is the second largest department in the University of Utah School of Medicine and one of the largest pediatric departments in the country. We are committed to improving the lives of children through excellence in advocacy, education, research, and clinical care. For more information about the Department of Pediatrics, please visit: http://medicine.utah.edu/pediatrics/. Mutual respect and appreciation are highly valued in the department.

The University of Utah offers a comprehensive benefits package including:

• Excellent health care coverage at affordable rates (see the Summary Comparison for more information)
• 14.2% retirement contributions that vest immediately
• Generous paid leave time
• 11 paid Holidays per year
• 50% tuition reduction for employees, spouses, and dependent children
• Flex spending accounts
• University provided basic employee life insurance coverage equal to a salary of up to $25,000
• Variety of elective insurance coverage, including life insurance, short and long-term disability, accidental death & dismemberment, accident, critical illness, hospital indemnity, and pet.
• Free transit on most UTA services
• Employee discounts on a variety of products and services, including cell phones & plans, entertainment, health and fitness, restaurants, retail, and travel
• Professional development opportunities

Additional benefits information is available at https://benefits.utah.edu/.

Responsibilities

Essential Functions

1. Manages daily operations of the Primary Children’s Outpatient Services Reception Desks and Prior Authorization Team. Plans, directs and manages the receptionist staffing schedule and prior authorization team assignments. Coordinates the availability of translation services for patients cared for in Department of Pediatrics specialty clinics. Monitors patient volumes and clinic throughput and identifies areas for improvement.
2. Directly oversees processes involving interviewing, hiring, and training new and existing staff. Oversees professional development of the front desk staff and prior authorization teams. Provides feedback on staff performance, completes 3-month, 5-month and annual staff evaluations using the University of Utah Performance Management (UUPM) tool, and recommends pay increases.
3. Enforces the written standards of practice, policies, and procedures, and initiates corrective action as necessary. Assists in the revision and addition of relevant policies and procedures.
4. Monitors daily performance and productivity. Organizes and conducts monthly staff meetings and provides advanced team-based training. Conducts routine staff huddles.
5. Responsible for ensuring timecard accuracy for staff in KRONOS. Reviews and approves employee leave requests, validates employee timecards, addresses discrepancies, enforces payroll and time and attendance policies, monitors trends, and maintains records.
6. Participates in the development and implementation of operational standards and clinic workflows. Participates in operational committees to establish customer service standards and implements plans for improvement. Supports division compliance with department policy and health care standards.
7. Ensures customer satisfaction by analyzing complaints, concerns, and suggestions and providing appropriate follow-through. Oversees customer service provided by registration and prior authorization staff and the patient experience related to the courtesy of staff. Serves as a key resource to identify, research, and resolve problems and complaints.
8. Monitors and reports on denial rates and works with staff to prevent denials related to incomplete registrations. Ensures co-pays are collected and full registrations are completed at the time of patient appointments.
9. Orders materials and supplies for reception area and the prior authorization team. Monitors inventory and efficient use of supplies and resources.
10. Assists with determining, implementing, and monitoring call metrics. Ensure that metrics are being met; communicates deficiencies with enterprise administration. Advises on staffing needs based on call volumes and prior‐authorization requests/demands.
11. Guides staff in the mission, vision, and values for the Department of Pediatrics, which is to provide excellent services to our patients, caring for children and caring for their future.
12. Maintains a current knowledge of HIPAA policies and all legal requirements for managing patient records. Informs senior leaders and managers of changes that will impact the department and provides recommendations for improvement and compliance.
13. Assists in planning short- and long-range goals for the enterprise and department.
14. Maintains department records and prepares monthly reports.

Disclaimer

This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Problem Solving

Often selects from a predetermined list of alternatives and sometimes recommends or changes policy and procedure based upon amount of discretion given by department. Problems would be referred to superior based upon predetermined guidelines set by the department.

Work Environment and Level of Frequency typically required

Nearly Continuously: Office environment.

Physical Requirements and Level of Frequency that may be required

Nearly Continuously: Sitting, hearing, listening, talking.

Often: Repetitive hand motion (such as typing), walking.

Seldom: Bending, reaching overhead.

Minimum Qualifications

Bachelor’s degree in a related area or equivalency (one year of education can be substituted for two years of related work experience). Four to six years of progressively more responsible management experience. Background knowledge of hiring department’s area of specialization in order to analyze, plan and draw conclusions for recommendations to superiors. Demonstrated leadership skills in planning and directing employees and processes in order to effectively monitor and develop subordinates and to ensure the smooth operation of department.

Completion of provided supervisory training within one year of employment may be required.

Master’s degree in a related area may be preferred.

This position is patient-sensitive and must fulfill all associated requirements. We protect our patients, coworkers, and community by requiring all patient-sensitive employees to be immunized according to CDC standards and hospital policy. Limited exemptions may be made for documented medical contraindications or religious beliefs that object to vaccinations.

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Preferences

Preferences

• Excellent customer service skills
• Good communication skills and ability to work effectively with diverse personalities
• Extensive computer experience is essential
• Experience with iCentra and Epic Applications
• Ability to work under pressure with frequent interruptions and multiple priorities are critical to ensure smooth operation of the office
• Previous clinical experience leading the front desk and prior authorization operations
• Previous experience training staff/coworkers and managing training materials
• Master’s degree in related field may be preferred

Applicants will be screened according to preferences.

Additional Information

The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Human Resources at (801) 581-7447 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or University Human Resource Management at (801) 581-7447 if you have questions regarding the post-retirement rules.

This position may require the successful completion of a criminal background check and/or drug screen.

The University of Utah values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patients.

All qualified individuals are strongly encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.

The University of Utah is an Affirmative Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran’s status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both.

To request a reasonable accommodation for a disability or if you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity and Affirmative Action (OEO/AA). More information, including the Director/Title IX Coordinator’s office address, electronic mail address, and telephone number can be located at: https://www.utah.edu/nondiscrimination/

Online reports may be submitted at oeo.utah.edu

https://safety.utah.edu/safetyreport This report includes statistics about criminal offenses, hate crimes, arrests and referrals for disciplinary action, and Violence Against Women Act offenses. They also provide information about safety and security-related services offered by the University of Utah. A paper copy can be obtained by request at the Department of Public Safety located at 1658 East 500 South.

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