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Manager-Eldercare Business Office

As Mount Sinai grows, so does our legacy in high-quality health care.

Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital,dedicated to continuing the training of the next generation of medical pioneers.

Culture of Caring: The Sinai Way

Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Position Responsibilities:

•  In collaboration with department leadership, reviews and revises department policies/procedures as necessary. Ensures the appropriate distribution and education of department policies/procedures.
• Ensures the management of data collection, aggregation and dissemination across the continuum, specific to clinical, financial and operational performance for designated area of responsibility. This includes, but may not be limited to, concurrent and retrospective chart audits as necessary.
• Maintains and monitors daily reports to ensure appropriate staffing levels based on unit of service standards.
• Responsible for Part D including: annual bid, Fraud Waste and Abuse Plan, PBM claims, PBM reports and action items, CMS reporting and all compliance and reporting requirements.
• Responsible for oversight of TPA including: claims, appeals, denials, vendor set up and payment rules.  Serves as Eldercare's liaison to TPA.  
• Responsible for accounts receivable including the collection of any outstanding accounts in a timely manner and all accounts payable. 
• Leader for Eldercare benchmark data identification, collection and analysis.  Utilization of this data for performance improvement activities with the Director and Eldercare Managers.
• Leader of the Month End Close Process, updates reports and processes as needed to improve the accuracy and efficiently of the close process.
• Responsible for the oversight and day to day management of the Eldercare's Managed Care Provider Network.  Including identifying new providers when needed, contracting, screening and credentialing of all providers.  Implements or oversees tracking of network contracts and credentialing to ensure all items are current and follow established regulations and Eldercare's policies.  Performs new provider orientation and audits.
• Works with MSMC HR, Employee Health, Education and other departments to ensure all PACE required employee requirements are in place and updated as regulations change and performs routine audits to ensure all required items are in place and current.
•  Promotes effective communication and collaboration between the Business Office and members of the healthcare team (physicians, nurses, support services, enrollment and other community agencies and resources).
• Participates in risk scoring and pharmacy benefit managers Part D reviews with Medical Director and clinic leadership at least monthly; addresses concerns with the Director from staff.  Assists in improving these reviews and updating this process as needed.    
• Identifies and develops action plans to improve Eldercare operations as related to the financial operations of PACE in collaboration with the director, interdisciplinary team, enrollment and MSMC departments. 
• Identifies opportunities and strategies to improve department processes to meet the evolving needs of the participants served, Eldercare  and the community. Monitors and reports department quality, service and cost outcomes.
• Supports the director in implementing objectives and recommending improvement that support the vision and mission of the organization. Demonstrates awareness and support of department objectives during interactions with staff and customers.
• In coordination with and in support of the director, plans and conducts meetings, encourages open communication and verbalization of opinions in an attempt to identify and resolve problems within the department.
• Participates in hiring, reviews, discipline, and grievance handling to ensure optimal individual and team performance.
• Participates in staff development activities, interacting as needed with the director, customers, and others to continuously improve competency and effectiveness of the department.
• Identifies and addresses skills or behaviors requiring improvement, both at an individual level and at a department level.
• Provides coaching as needed to optimize performance and ensures optimal customer service.
• Engages in self-development in professional, and managerial areas; successfully completes leadership development curriculum.
• Adheres to standards, policies and procedures at Eldercare, the hospital and Departmental level.
• Promotes a service orientation in the performance of position duties and responsibilities and in interactions with participants, staff and visitors.

Qualifications:

• Master preferred or Bachelor's Degree in accounting, finance, business administrator or related field. Project management, Lean or Six Sigma certification helpful.
• 5 years management experience required preferably in managed care or physician practice management.

Benefits:

We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs. Our robust employee benefits package includes:

• Health benefits
• Life insurance
• Long-term disability coverage
• Healthcare spending accounts
• Retirement plan
• Paid time off
• Pet Insurance
• Tuition reimbursement
• Employee assistance program
• Wellness program
• On-site housing for selected positions and more!