The Transplant Financial Manager (TFM) has oversight over the direction and management of the operational and programmatic aspects of health insurance compliance activities and government health insurance regulations for the entire transplant institute including the sub-specialties under its purview. Under the direction of the finance director of transplant, the TFM fulfills a leadership role and directly manages the entire transplant financial team, which includes but is not limited to, TFCs, TFC leads and TFC supervisors, to assure transplant patients’ medical services are covered by insurance, patients are effectively counseled regarding their insurance plans and benefits, and proper documentation and/or insurance authorizations are in place where needed to support for an effective and efficient revenue cycle.
Essential Duties:
- Collaborates with medical and surgical leadership to establish strategies for the different organ programs.
- Functionally integrates areas of responsibility within the institution in support of the mission, goals, and objectives of the transplant institute.
- Provides team cohesiveness, direction, education and facilitates growth and positive change to the transplant financial coordinators, guides/establishes workflow processes to accelerate financial clearance for patients and streamlines system operations.
- Utilizes problem solving techniques, process improvement and team development to ensure timely clearances for services, patient care, and a seamless patient and family experience.
- Completes operational requirements by scheduling and assigning employees and following up on work results.
- Participates and leads in meetings and discussions with transplant leadership and work with outside medical groups and health plans to form professional working relationships to benefit patient care. Assists the finance director and/or administrator with strategic planning to address volume growth, system and workflow changes, gaps in coverage, staff underperformance, lapse in turnaround times and other issues that impede prompt service.
- Creates written workflows, protocols and process improvement plans to benefit financial clearance throughput and increase responsiveness to clinical staff requests.
- Manages adhoc or urgent requests assigned by the director, transplant administrator, clinical leadership, or as situations arise which require immediate resolution. Provides full financial administrative support for all programs by acting as the manager on-call which may include after-hours and weekends.
- Performs recruitment, selection, orienting and training new staff. Responsible for the progressive discipline of staff in accordance to company policies and procedures.
- Participates in creation of key performance indicators, be responsible for monitoring and tracking staff performance, and help the team achieve these metrics. This will include identifying and implementing resolutions to counter any gaps in performance or service. Ensures training and competency of the entire team.
- Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies.
- Performs other duties as assigned.
Required Qualifications:
- Req High school or equivalent
- Req 5 years 5+ years of financial coordination experience preferably in a transplant program or at least 3+ years in a project management or in a lead/supervisory role or capacity.
- Req Broad knowledge of health insurance terminology, health insurance process and transplant process required.
- Req Must have in-depth knowledge and experience of transplant finance, insurance & health plans/medical groups, transplant authorizations and the financial clearance process.
- Req Proficiency in database & EMR systems (e.g. OTTR, Cerner, Trace, GECB) and in office software suites (e.g. MS Office).
- Req Demonstrated ability to problem-solve and provide effective resolution.
- Req Demonstrated leadership skills and ability to provide education and support to staff.
- Req Ability to time-manage, high-stress environment required. Weekend and after-hours consultation as required.
- Req Demonstrates advanced knowledge and experience in transplant finance and health insurance.
- Req Demonstrates intermediate knowledge of OPTN/UNOS policies and the role of CMS in transplant.
- Req Demonstrates excellent verbal and written skills and advanced knowledge of hospital and transplant IT systems as they relate to financial clearance and insurance.
- Req must have the ability to time manage and work through a high stress environment
- Req Must possess strong analytic skills and be able to evaluate and analyze data—using it to drive process improvement and impact positive change and outcomes
Preferred Qualifications:
- Pref Bachelor’s degree in a related field
- Pref Bilingual preferred; bilingual certified department translator strongly preferred.
- Pref Certification – Job Relevant Bilingual certified strongly preferred; if bilingual certified department translator.
- Pref Certification – Job Relevant Certified Transplant Financial Coordinator (CTFC) preferred.
Required Licenses/Certifications:
- Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
The annual base salary range for this position is $95,680.00 – $158,230.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
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