Clinical Operations Manager (Pre-certification) - Dallas, TX

Are you an innovative, energetic, and forward thinker? If you answered yes, then this position is for you! Tenet is currently hiring for a Clinical Operations Manager to head up our new Pre-certification branch within our Clinical Resource Center. In this hands-on role you will be the driving force behind new client implementations, development of new clinical service offerings, and making sure you are providing sound solutions to our external customers. Ready to expand your career? Apply today.

Day to day supervision of all pre-certification clinicians. Including, serving as a clinical resource providing solid, fact-based clinical direction, analyzing data related to turn-a-round timeframes, quality assurance, productivity standards, recovery, payor trends, etc., and implementation of  corrective action based on identified opportunities.Responsible for performance management/coaching, development of policy and procedures as business needs dictate, and provision of sound revenue cycle solutions related to opportunities identified in the clinical dispute arena. Conducts coaching and performance management as appropriate; develops/organizes educational programs  in response to identified developmental needs; conducts inter-rater reliability studies biannually.Provides monthly reports in conjunction with Analytics of key indicators such as: productivity, turn-around time, quality assurance, recovery, education tracking. Monthly reports will be sent to Operation Directors, Dispute Managers, Directors of Revenue Assurance, and Director of Clinical Dispute Operations. Manages IT and access needs both support and equipment in conjunction with HIM and Perot and assures telecommuters meet company standards/requirements Conducts hiring process for all PFS pre-certification clinicians. Collaborates and engages external customers such as facility case management in opportunities for prevention of future disputes; identifies potential process gaps and provides sound solutions to external customers.

QualificationsLeadership experience and project management experience is a must.  The candidate would be responsible for helping us further explore and develop clinical service offerings, refine the existing pre certification process in the Center for Patient Access Services and directly manage 3-15 pre certification clinicians.Applicant possesses excellent written and verbal communication skills, demonstrates clinical expertise in at least 2 areas of nursing. Demonstrates solid competency level in application of InterQual criteria utilizing both the electronic and text version of the tool Demonstrates computer literacy with a solid knowledge base of Microsoft Office suite including Word, Excel, Powerpoint a plus. Possesses a solid knowledge base of the revenue cycle and patient accounting principles; demonstrated competency in IQ criteria application. RN or LPN license, BSN preferred.  Certification in a clinical specialty area or other area such as Case Management, UR, Medical Auditing, a plus.   At least 5 years as an RN with expertise in at least 2 areas of clinical nursing; prior dispute management, utilization review and/or case management experience a plus Possesses solid knowledge base of the revenue cycle including providing sound revenue cycle solutions in response to clinical disputes 2 years in a patient accounting environment, and at least 2 years in a managerial and/or leadership role. Must be willing to travel 25-50%    Position will be based at either the Frisco, TX business office or Dallas, TX headquarters office-willing to pay relocation for out of state candidates. Tenet Healthcare offers a competitive compensation and benefits package that includes tuition reimbursement, paid time-off, fitness/toll-road reimbursement, employee stock purchase program, discounted cell phone service, 401(k) match and much more!