This position is 50% Leadership and 50% Negotiating and is responsible for leadership duties as assigned, including but not limited to: overseeing projects, teammate development, utilization management, interviewing candidates, quality assurance, drafting PDR’s, and engaging in performance management
efforts. This position is also expected to be responsible for metric/report development, ad-hoc reports, maintenance of routine reports, and special projects as it relates to revenue operations and external partner needs, which may include root-cause analysis and process re-design.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive.
Leadership and Special Projects (50%)

• Teammate development
• Patient utilization review and reporting
• Monitoring DaVitaSPA Inbox
• Interviewing and onboarding new teammates
• Reviewing and approving Single Patient Agreements – pending, denied, and executed
• Oversee various projects, meet deadlines, and handle multiple priorities in a fast-paced, ever changing and evolving business environment with shifting time frames
• Assist with CQI (Continuous Quality Improvement) projects or other efforts designed to improve effectiveness/efficiency of the business
• Identify system and process improvements opportunities and make recommendations
• Other Leadership responsibilities as assigned

Negotiator (50%)

• Monitor team workflow to ensure established priorities are met
• Train, coach, and develop teammates; respond to questions knowledgeably
• Escalate teammate performance issues to Supervisor
• Assist Supervisor as requested in evaluation of teammates
• Participate with Supervisor in setting departmental goals
• Attend leadership meetings to help resolve problems
• Escalate operational problems to Supervisor
• Contact payors to verify benefits and eligibility, authorizations or pre-certifications (in and out-of network benefits)

The above statements describe the general nature and level of work being performed by individuals employed in this position. This job description is not intended to be an exhaustive list of all duties and responsibilities required in this position. This job description does not constitute an employment contract.

• Review patient notes and history, claims, benefits, and eligibility, prior to payments or nonpayments
• Negotiate Single Patient Agreements (SPAs) balancing conflicting requests and obtaining appropriate resolutions within DaVita guidelines
• Create, sign, and approve agreements in accordance with department guidelines and established parameters
• Maintain detailed and accurate data for all SPAs for payment trend analysis and future negotiations
• Request billing system changes as needed
• Establish and maintain good working relationships with both payors and internal partners
• Participate in special projects related to patient research by coordinating with Payor Contracting and other departments
• Other duties and responsibilities as assigned including but not limited to:
• Assist in scheduling and facilitation of team meetings
• Cross-train in other department functions
• Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
• Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position

MINIMUM QUALIFICATIONS:

• Associate’s degree required or combination of education and progressively responsible work experience may be substituted in lieu of degree on a year-for-year basis
• Minimum of three (3) years leadership experience in a professional environment required, including but not limited to: Solid data analysis experience, Project management skills, Strong communication skills
• Intermediate computer skills and proficiency in office applications (MS Excel, Access, Word, Outlook, PowerPoint, etc.)
• Ability to read, comprehend, and communicate content in Payor Contracts

PREFERRED QUALIFICATIONS

• Bachelor’s degree in related area preferred
• Experience developing teammates
• Prior health care reimbursement / revenue cycle experience
• Project management
• Prior negotiation experience

What We’ll Provide:

More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.

• Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
• Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
• Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning.

Salary/ Wage Range

Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience and may fall outside of the range shown. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits