"Alerted.org

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

601 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

500183 Health Insurance Counseling

Work Shift:

UR - Day (United States of America)

Range:

UR URC 209 H

Compensation Range:

$25.09 - $35.12

_The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._

Responsibilities:

Oversees team responsible for reviewing referrals for medical necessity and appropriateness of level of care. Assists patients with questions regarding referrals. May assist in obtaining authorizations for hospital services and ensure that the appropriate referrals are received prior to service. Supervises team and provides technical assistance.

ESSENTIAL FUNCTIONS

+ Develops, maintains and teaches training program for new employees.

+ Assesses staff's ongoing training needs, develops and implements training programs to address needs.

+ Performs personnel administration, including recruitment, hiring, termination, performance evaluation, and performance improvement plans.

+ Provides supervision, leadership, coaching and counseling. Serves as a role model and facilitator to staff.

+ Ensures efficient and quality functions through high-cost reporting, work queues, and case review.

+ Maintains departmental standards through quality assurance monitoring.

+ Identifies problems or areas for system improvements and develops and implements resolution.

+ Monitors customer satisfaction and acts on customer feedback to improve the quality of service.

+ Analyzes volume and productivity and works in the staffing pattern as required to meet department standards.

+ Collaborates with departments to integrate operations with other components of URMC, such as Financial Case Management, RIM, Utilization Management, Social Work, Patient Accounts, Medical Records, Finance, and Legal.

+ Serves as a liaison to patients, physicians, nursing, social workers, other URMC staff, insurance companies. Serves on committees/teams as designated.

+ Responsible for reviewing, validating, and maintaining accurate departmental procedures. Interprets hospital and administrative policies.

+ Interprets third-party payer requirements and related regulations to ensure requirements are met through insurance bulletins and compliance reviews.

+ Ensures Joint Commission Compliance.

+ Collaborates with Manager to identify strategic goals and objectives.

+ Develops and implements annual plan to accomplish goals.

+ Other duties as assigned.

MINIMUM EDUCATION & EXPERIENCE

+ Bachelor's degree and 2 years of relevant experience required

+ Or equivalent combination of education and experience

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.

Notice: If you are a **Current** **Employee,** please **log into myURHR** to search for and apply to jobs using the Jobs Hub. Your application, if submitted using this portal, cannot be moved forward.

Learn. Discover. Heal. Create.

Located in western New York, Rochester is our namesake and our home. One of the world’s leading research universities, Rochester has a long tradition of breaking boundaries—always pushing and questioning, learning and unlearning. We transform ideas into enterprises that create value and make the world ever better.

If you’re looking for a career in higher education or health care, the University of Rochester may offer the perfect opportunity for your background and goals

At the University of Rochester, we are committed to fostering, cultivating, and preserving an inclusive and welcoming culture and are united by a strong commitment to be ever better—Meliora. It is an ideal that informs our shared mission to ensure all members of our community feel safe, respected, included, and valued.