Patient Financial Services Manager - Program Management II

Full Job Description

Weekly Hybrid Working Arrangements

Minimum 2 days In Office and Maximum 3 days Remote Work

[8-5 PM]

[Mondays and Tuesdays in-office]

This position will comply with the CFO's office current

working arrangements.

Please note: Work arrangements are subject to change at any time.

About The Work Unit

The Mental Health Hospitals at Fort Logan and Pueblo, and Forensic Services, under the auspices of the Office of Civil & Forensics Mental Health (OCFMH), partner with patients, families, and their communities to provide quality services that help patients achieve their mental health and health care goals. In addition, the Mental Health Institute at Pueblo is the only Colorado facility with a forensic division that serves adults who are found Not Guilty by Reason of Insanity or found Incompetent to proceed.

The Patient Financial Services work unit must identify and record the gross revenue for all patient client services assigned within the District. Currently, the agencies served are the Colorado Mental Health Institute at Pueblo, Colorado Mental Health Institute at Ft Logan.

The purpose of Patient Financial Services is to 1) earn revenue In accordance with the Colorado Revised Statutes and Long Bill requirements, from all sources of income, 2) serve as trustee for patient funds, if needed, 3) assure that patients access all eligible benefits in a timely manner, and 4) develop and produce financial reports that accurately assess the status of all revenue requirements for agencies within the southern Accounting District's area of responsibility.

The Patient Financial Services Office is located on the grounds of the Colorado Mental Health Hospital at Pueblo (CMHHIP), and the primary customer of the Patient Financial Services work unit is the Mental Health Hospitals at Pueblo and Ft Logan.

Requirements

About This Position
The purpose of this position is to serve as the Manager of Patient Financial Services for Colorado’s two Mental Health Hospitals in Pueblo and Fort Logan. Responsible for oversight and management of all revenue and billing activities assigned to the Department of Human Services Mental Health Hospitals, including recording and collecting of revenue in CORE, Colorado’s financial system, pursuant to Colorado State Statutes for patients admitted to the hospitals. Responsible for the determination of payment liability for patients sent to outside acute hospitals, monthly reconciliation of revenue with analysis and reporting.
Other duties include:

Organizational Management and Supervision:

• Unit supervisor for 10 staff members, including direct supervision of 3 individual units: Medicare/Other Insurance, Medicaid/Self- pay, and Audit, including 3 professional staff, 6 technicians.
• Develops performance plans and evaluations; approves performance plans and evaluations; administers corrective actions; initiates disciplinary actions; approves leaves; assigns work schedules; resolves informal grievances; establishes acceptable work standards; sets priorities; initiates hiring process; interviews possible applicants; recommends hire, promotion, or transfer.
• Oversee, direct, and serve as the subject matter expert for all operational activities within Patient Financial Services for both State Mental Health Hospitals, including: interpreting rules and regulations as they pertain to patient benefits and revenue for the Hospitals, Medicare, Medicaid, and Fiduciary Duties.
• Interprets, analyzes, and keeps apprised of current and proposed reimbursement regulations, statutory requirements, and legislation that may affect reimbursement.
• Represent the Division and/or Agency as assigned in providing expertise in patient billing and revenue issues, or any other matters as assigned.
• Responsible for revalidating Medicare and Medicaid enrollments and updating them when changes occur.
• Provide expertise, guidance, direction, and training to Patient Financial Services personnel. Communicate internal and external goals, process changes, and roles/responsibilities to employees. Formulate and implement new processes and improvements to workflow and problem resolutions.
• Schedule and assign workload at the department and functional unit levels, establish and review acceptable work standards and expectations for staff. Provide project support to managers to meet state, department, and internal objectives.
• Position is exempt and may be required to work in excess of 40 hours per week to complete assigned duties, meet deadlines, or as requested by supervisor.

Revenue:

• Report the financial status of the Mental Health Hospitals at Pueblo and Fort Logan to the Department of Human Services management by monitoring, analyzing, and projecting patient revenue, and by collecting financial and clinical information to track current trends that could impact revenue and ensure compliance with legislative appropriations.
• Explore all sources of reimbursement, thoroughly pursue all avenues of appeal, and appropriately apply the Ability to Pay (ATP) procedures.

Review patients’ personal funds by acting as fiduciary or personal representative in order to ensure that patients do not unnecessarily become ineligible for benefits, thus protecting patient assets in accordance with all governmental and statutory requirements.

This may include meeting with patients, patients’ family, and/or hospital staff to discuss and provide guidance for financial issues that may arise.

• Represent the Colorado Department of Human Services as a witness in estate, bankruptcy settlements, and court hearings regarding claim appeals and debt collection proceedings to ensure the Department gets appropriate reimbursement for provided services.
• May be required to drive a state vehicle to out-of-town meetings to represent CDHS as needed.
• Ensure all patient financial services operations comply with Generally Accepted Accounting Principles (GAAP), accounting and financial reporting standards established by the Governmental Accounting Standards Board (GASB), Financial Accounting Standards Board (FASB), Colorado Fiscal Rules and Fiscal Procedures Manual, Code of Colorado Regulations, policies and procedures of agencies and external organizations, including the IRS, Office of the State Auditor, Office of the Attorney General, Centers for Medicare and Medicaid Services policies and procedures (CMS), and Office of the State Controller.

Audits:

• Responsible for Patient Financial Services' annual State Financial Audit, financial components of program and performance audits, CDHS Internal audits, fiscal fraud audits, or audits of external entities for Patient Financial Services processes and transactions.
• Responsible for preparing variance analysis documentation and explanations, developing audit finding responses, creating and implementing internal controls, policies, and procedures to comply with audit recommendations.

Other Duties As Assigned:

• Any other duties that may arise in the course of performing duties of this position that aren’t covered in the above duty statements.

Qualifications

Experience Only:

Nine (9) years of relevant experience in an occupation related to the work assigned to this position

Or

Education and Experience:

A combination of related education and/or relevant experience in an occupation related to the work assigned equal to nine (9) years.

Preferred Qualifications:

• Experience in Accounting, Healthcare Billing, Revenue Reconcilitation, Booking/Recording Revenue, and AR collections.

• Education in Healthcare Admin, Accounting, or Finance.

• Experience in extracting and analyzing financial data; proficiency in using Microsoft Office (Access, Excel, Word, and PowerPoint); and experience in financial and accounting information systems.

• Preference will be given to candidates with experience in: Electronic Health Record, CORE, and any previously used state
  financial systems.

• Previous State Experience.

• Experience with Avatar and CORE.

• Familiar with patient billing, Medicare/Medicaid rules and regulations, Colorado Revised Statutes related to billing and the Institutes, Social Security Administration rules and regulations, and experience with supervision.

• Ability to communicate with patients, their families, etc.

• Proficient with Microsoft Access.

• Proficient with Microsoft Word.

Special Qualifications:

Required knowledge and experience in Health Care Provider reimbursement methodologies, including but not limited to: Capitation, Fee For Service, Per Diem, Case Rate, Stop Loss, Percentage of Billed Charges, and working knowledge of various healthcare codes (CPT, DRC, HCPC, ICD, Revenue, and others).

Extensive understanding of Accounting principles, entering Journal Entries and interactions on the general ledgers, and revenue reconciliation.

Conditions of Employment:

• Full background check and reference check required

• This position requires State of Colorado residency at the time of application (unless otherwise identified in the posting), and residency within the state throughout the duration of employment in this position.

• Motor Vehicle Check

• Must possess a valid, non-restricted Colorado Driver’s License or an non-restricted U.S. Driver's License for positions within 30 miles of the CO state border

• Out-of-State Driver’s License holders must obtain a valid, non-restricted Colorado Driver’s License within 30 days of employment start date.

• Travel: Occasional travel necessary to attend training, using state fleet vehicle

• Other: TB Testing and any other vaccinations required by the State of Colorado
  May be required to work in excess of 40 hours per week to complete assigned duties, meet deadlines or as requested by supervisor.

• Former State employees who were disciplinarily terminated or resigned in lieu of termination must:

1. Disclose that information on the application.

2. Explain why the prior termination or resignation should not disqualify you from the current position.

3. Provide your employee number from your prior State employment. Absent extraordinary circumstances, prior disciplinary termination or resignation in lieu of termination and failure to provide this information will disqualify the applicant from future State employment with CDHS.

CDHS Selection Process Explanation

Employment history is calculated on a full-time basis (40/hrs per week). Part-time employment is calculated on a prorated basis to determine qualifications.

Be sure your application specifically addresses your qualifications, experience, work products, and accomplishments as they relate to the position and minimum requirements.

• Preferred Qualifications & Competencies:

  • Relevant years of state service experience.

Minimum Qualification Screening Process

A Human Resources Analyst will review the work experience/job duties sections of the online job application to determine whether your experience meets the minimum qualifications for the position.

You must complete the official State of Colorado online application. Cover letters and resumes WILL NOT be reviewed during the minimum qualifications screening process.

You must specifically document your work experience and qualifications. Do not use "see resume" or "see attached."

You must meet the minimum qualifications to continue in the selection process. Part-time work experience will be prorated.Comparative Analysis Process – Structured

Application Review

After minimum qualification screening, the comparative analysis process will involve a review and rating of all the information you submit.

Your Work Experience/Job Duties

Document your work experience/job duties to the extent to which you possess the skills, education, experience, minimum qualifications, and preferred qualifications.

If listed, answer all supplemental questions as your answers to these questions will be evaluated during this phase. Provide at least 4-8 sentences for each supplemental question.

Supplemental Questions

Answer the supplemental questions completely and thoughtfully. We will rate your answers based on the content of your response and your writing skills (spelling, grammar, and clarity of your writing).

Appeal Rights

You may file an appeal with the State Personnel Board or request a review by the State Personnel Director if your application is eliminated. You will find the appeals process, the official appeal form, and how to deliver it on the State Personnel Board website.

• You or your representative must sign and submit the official appeal form for review.

• You can find the official appeal form here.

• You must be deliver the official appeal form to the State Personnel Board:

  • By email (dpa_state.personnelboard@state.co.us), or

  • Postmarked in US Mail to(1525 Sherman Street, 4th Floor, Denver CO 80203, or

  • Hand delivered (1525 Sherman Street, 4th Floor, Denver CO 80203), or

  • Faxed (303.866.5038) within ten (10) calendar days from your receipt of notice or acknowledgement of the department’s action.

Contact the State Personnel Board for assistance:

• At (303) 866-3300, or

• Refer to the Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, within the Rules webpage.

Additional Information

• How to apply to the State of Colorado(Youtube Video, Runtime 3:59, Closed Captions Available)

• The Assessment Process

• For Statewide Hiring Freeze NON-EXEMPTED position ONLY:

  • This job offer is contingent upon funding availability from all sources, including state and federal (if applicable), to start or continue.

• For additional recruiting questions, please contact Jeru Marshall: jerusalen.marshall@state.co.us

About Us & Benefits

If your goal is to build a career that makes a difference, join the dedicated people of the Colorado Department of Human Services (CDHS).

Our professionals strive to design and deliver high quality human and health services that improve the safety, independence, and well-being of the people of Colorado.

Each of us is committed to contributing to a safe and accessible CDHS. In addition to a great location and rewarding and meaningful work, we offer:

• Strong, secure, yet flexible retirement benefits including a PERA Defined Benefit Plan or PERA Defined Contribution Plan plus 401(k) and 457 plans

• Medical and dental health plans

• Employer supplemented Health Savings Account

• Paid life insurance

• Short- and long-term disability coverage

• 11 paid holidays per year plus vacation and sick leave

• State of Colorado Employee BenefitHub Resource Center

• Employee Wellness program

• Excellent work-life programs, such as flexible schedules, training and more

• Remote work arrangements for eligible positions

• *Some positions may qualify for the Public Service Loan Forgiveness Program.

Our Values

We believe in a people-first approach: We prioritize the needs, well-being, and dignity of the individuals, families and communities we serve.

We commit to respect, fairness and access in every decision, policy and interaction. We engage client voices and experiences in the development and implementation of the services we provide.

Balance creates quality of life: We want our team to be resilient through a supportive workplace that values flexibility, health and wellness, and employee engagement.

We hold ourselves accountable: We take responsibility through our actions, programs, and results for the state of health and human services in Colorado.

Transparency matters: We are open and honest with employees, our partners, the Coloradans we serve, and the public.

We are ethical: We abide by what is best for those we serve by doing what is right, not what is easy.

Collaboration helps us rise together: We work together with all partners, employees, and clients to achieve the best outcomes for Coloradans.

ADA Accommodations

CDHS is committed to a Colorado for ALL qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment.

This includes completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or performing essential job functions where the requested accommodation does not impose an undue hardship.

If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to cdhs_ada@state.co.us.

EEO Statement

The State of Colorado is an equal opportunity employer

We are committed to increasing a “Colorado for ALL" of our staff and providing culturally responsive programs and services.

Therefore, we encourage responses from people of all backgrounds and abilities.

The State of Colorado believes that a “Colorado for ALL” drives our success, and we encourage candidates from all identities, backgrounds, and abilities to apply.

The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them.

Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.

Additional Support For Your Application

Toll Free Applicant Technical Support

If you experience technical difficulty with the NEOGOV system (e.g.

uploading or attaching documents to your online application) call NEOGOV technical support at 855-524-5627 Mon-Fri between 6 am and 6 pm (Pacific Time).

Helpful hints: if you are having difficulty uploading or attaching documents to your application 1) ensure your documents are PDF or Microsoft Word files and 2) close the document before you attempt to upload (attach) it.