Director, Healthcare Advocacy

DIRECTOR, HEALTHCARE ADVOCACY

 

Summary/Objective:

The Healthcare Advocacy Director assists in the strategy, formulation and execution of staffing, performance, and production levels in the department consistent with contract requirements. This position functions primarily in the role of establishing and maintaining the appropriate levels of leadership, authority, productivity, communication, and day-to-day management of the assigned department.

 

Primary Duties:

• Lead our growing Advocate program. Communicate the vision, goals and execution of the program. Will provide support and expertise with other leaders involved in the advocacy program stand-alone piece of the advocacy solution but also as part of the entire Trustfolio e-Advocacy solution.  

• Collaborate with Business Development, Sales, Product and Marketing teams to develop and define the unique selling proposition and messaging of our e-Advocacy solution.
• Conduct presentations on the advocacy solution for customers, executives, and external marketing activities.
• Provide expertise to the team to identify key customer pain points that our technologies solve.
• Contribute industry expertise, operations requirements, and member feedback to support the direction of our advocacy products and services.
• Collaborate with leadership team to improve efficiency and efficacy of services via internal and external data analysis.
• Define the e-advocacy product and services vision and charter.  Own client lifecycle from prospective client discussions, implementation, support and regular client reviews.
• Identifies, distributes, and balances workload and tasks among staff in accordance with established workflow, skill level, and/or occupational specialization.

• Coach, develop, and mentor staff to achieve quality performance and grow leadership skills

Management Duties

• Hires, trains, terminates employees according to department needs.
• Lead teams of healthcare advocates, healthcare coordinators, and other staff. 
• Lead, develop, and provide advocacy training for employees virtually (some in-person training may be needed).  Advises team on work methods, practices, and procedures and identifies parameters of a viable solution.
• Manages employee payroll time, including verifying timecard entries are correct.

• Establish and provide annual performance goals for team members

• Adjusts workload in accordance with established priorities to ensure timely and accurate completion of assigned team tasks.
• Monitors and reports on the status and progress of work and adjusts in accordance with established priorities. Reviews and/or prepares productivity and other reports, as requested.
• Articulates and communicates to the team the schedule, assignment, project, problem to be solved, actionable events, milestones, program issues under review, and deadlines for completion.
• Develops and maintains instructions, policies and procedures, reference materials, and supplies.
• Acts as a liaison between the individual and their care team.
• Maintains responsibility for assuring an efficient advocacy case review process.
• Identifies and corrects problem areas on a case-by-case basis and system-wide basis.
• Conducts mandatory case review and quality assurance activities as stipulated by contract(s).
• Collaborates regularly with team members and staff to analyze advocacy data for development and implementation of advocacy improvement projects.
• Protects the confidentiality of patient information through compliance with the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH).
• Performs other duties as assigned.

 

Essential Knowledge:

Comprehensive knowledge of claims/billing; benefit support, healthcare Navigation; Healthcare resources; provider resolutions/communication; mental health; disease support; transition of care; end of life support and medication/pharmacy. Working knowledge of social work, nursing and medical procedures and practices. Familiar with International Classification of Diseases 10th Revision Clinical Modification / Procedure Coding System (ICD-10-CM/PCS) and other types of healthcare coding. Knowledge of the quality improvement theories, methods, and tools.

Essential Education:

• Graduate of an accredited school of nursing. BSN, MSN preferred.
• Active Registered Nurse (RN).
• Direct advocacy experience
• Prefer BCPA certification or will achieve certification within 3 months of employment.

 

Essential Skills:

Skilled in interpersonal relations and conflict resolution. Excellent customer service skills, coaching, data analysis. Knowledge of various healthcare payors (Medicare, Medicaid, MCOs/ACOs, value-based care, etc.). Experience and skill in word processing, basic spreadsheet, and presentation software applications; familiarity with database software programs (Microsoft Office). Excellent oral and written communications skills. Excellent interpersonal and problem-solving skills. Ability to organize and coordinate multiple simultaneous tasks in a team environment.

Organizational “Fit” Considerations:
Must be flexible and proactive in covering and overseeing services. This may require extended hours of work during the week, weekends, and on holidays, on demand or to prevent adverse situations from occurring. 

• Travel Requirements
  • Up to 10% or less travel requirement for this position

Virtual position