DaVita Kidney Care

Operations

• Researches and resolves high complexity collection account balances according to DaVita policies and procedures and compliance with federal and state billing regulations
• Provides ongoing training and guidance for Revenue Specialist teammates
• Performs data trending analysis, quality assurance reviews and review of key metrics
• Review weekly and monthly key metrics to identify trends or areas of focus
• Identify payer trends and/or root cause of billing or claim exceptions; take appropriate steps to resolve and/or escalate issues to minimize bad debt
• Escalate issues as needed; provide recommendations
• Act as resource for teammates' questions and assist with issues of focus and problematic payer issues
• Train new teammates and identify training opportunities to improve individual and team performance
• Perform close reconciliation approvals and related activities to ensure timely submission of primary, secondary and tertiary insurance claims
• Conduct quality assurance reviews of work output and provide feedback to teammates and management; offer suggestions for improvement
• Support department initiatives and stay abreast of changes to ESRD and Medicare Secondary Provider laws and changes

Revenue Specialist III

• Identify trends and perform root cause analysis on unpaid and underpaid claims
• Research, appeal, and resolve claim rejections, underpayments, and denials with appropriate insurance payor
• Develop and maintain positive working relationships with clinical personnel, teammates, and insurance representatives

Revenue Specialist II

Manager

• Manage complex health plan relationships
• Lead high-visibility negotiations and drive value across the traditional FFS portfolio
• Develop creative financial solutions to overcome barriers around contract language, rate transparency, and economics
• Act as a primary liaison between Payor Partnerships and other cross-functional stakeholders
• Foster a collaborative, high-performance team culture
• Lead complex payer negotiations, including new contract negotiations, rate renewals, and termination/expiration events
• Manage a multi-million-dollar portfolio of health plan relationships
• Organize joint operating committees and executive meetings to communicate DaVita's value proposition
• Manage, coach, and develop a team of direct reports (Managers and/or Analysts)
• Ensure appropriate delegation, project planning, and capacity forecasting
• Act as a thought partner for operational leaders, finance, strategy, and legal.

Senior Manager, Payor Partnership

• Research, initiate follow-up and resolve patient insurance registration and verifications for all patients
• Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution claims
• Proven ability to drive results, continuous improvement and significant growth
• Monthly reporting and managing workflow for high volume insurance portfolio
• Superior problem solving and analytical skills
• Strong organizational skills with an ability to effectively manage large amounts of detailed information
• Excellent oral and written communication skills
• Stay current on communications relating to healthcare reimbursement and regulatory changes
• Develop and maintain positive working relationships with clinical personnel, teammates, and payer representatives
• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
• Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position
• Understand and adhere to all policies, laws and regulations applicable to this role

Revenue Specialist, III

• This position functions autonomously and in collaboration with all members of the healthcare team to coordinate and facilitate quality, cost-effective care while minimizing fragmentation of the healthcare delivery system for ESRD and CKD patients.
• This position provides coordination of care between the patient, family, physician, provider and care teams, the community, and Regional Operations Manager.

RN Case Manager, Experienced

• Research and input system architecture changes for insurance setup objects in support of generating revenue and claims for billing
• Implement and resolve highly complex payer contract requirements into DaVita’s systems
• Respond to internal teams’ inquiries on contract, revenue, plan management and billing attributes
• Perform duties for the revenue operations department related to either contract management, revenue management or insurance plan management including billing templates (i.e. UB04, HCFA 1500)
• Communicate with insurance payers to understand network coverage, relationships and contract terms to ensure timely and accurate reimbursement for dialysis services rendered at our clinics
• Process payer, partner and customer requests to ensure center and payer information is loaded into the billing system for accurate billing including single patient agreements
• Respond timely and accurately to payer communications and bulletins
• Collaborate with other revenue operations teams to ensure seamless processes across teams
• Help identify process changes and opportunities for continuous improvements
• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
• Understand how setup objects/contract/payer requirements and system logic tie together in the billing system by collecting, analyzing, interpreting and summarizing data from source systems
• Attend team meetings, phone conferences, and training as scheduled
• May be asked to work overtime as needed

• Drive enterprise adoption and sustained utilization of IKC ConnectX products (e.g., NICE CXOne)
• Partner with operational leaders to ensure workflows are embedded consistently across national and clinical teams
• Identify barriers to adoption and coordinate training, communications, readiness, and feedback loops
• Partner closely with IKC Product to shape and operationalize solutions
• Establish and monitor success metrics tied to adoption, utilization, operational efficiency, teammate productivity, service levels, and patient engagement outcomes
• Identify, prioritize, and incubate innovation opportunities that improve clinical and operational workflows
• Drive efforts to unify platforms and standardize processes across roles and teams
• Build trusted relationships with IKC Operations, IKC Product, and adjacent stakeholders to align priorities

Director – IKC ConnectX Operations

• Lead approximately 10 dialysis centers and 200 teammates
• Provide oversight of operations with complete accountability for approximately $30-$50MM P&L
• Provide strategic and tactical leadership, counsel, and direction to field management
• Identify and develop strategic growth opportunities
• Monitor division performance
• Work closely with Divisional Vice President or SVP to develop competitive strategies
• Create a team powerhouse with approximately 10-12 direct reports
• Address top growth priorities, patient census, and successful operational conversions
• Develop and execute strategic operating plans and goals for assigned division facilities
• Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively

Regional Operations Director

• Lead a remote team consisting of approximately 9 Patient Pathways Dialysis Coordinators within the Patient Pathway program including but not limited to teammate relations, fostering a positive work environment, conducting annual performance and salary reviews, performance management, recruitment, retention, terminations, and related ePCNs
• Conduct regular update calls and operating reviews with each direct report
• Manage the hiring and onboarding process for Dialysis Coordinators in assigned territory
• Know, understand, implement and follow DaVita Teammate Guidelines and employment policies and procedures
• Schedule and organize new teammate training, including both classroom training and on-site shadowing
• Review financial statements and data
• Ownership of territory P&L
• Utilize financial data to improve profitability. Prepare and control operational budgets. Plan effective strategies for financial well-being of Patient Pathways.
• Implement new Patient Pathways Program across hospital partners
• Meet face to face with hospital partners to discuss current discharge processes
• Structure, introduce and train hospital partners on the Patient Pathway program
• Identify areas of improvement in the discharge process in individual local markets
• Conduct regular update check-ins with hospital partners and Patient Pathways management before, during, and after implementation
• Analyze, develop, and implement new ways for the company to differentiate itself in the marketplace
• Develop in-depth knowledge of the company's service offerings, markets, current market share within individual markets, market competition, and strategies to secure new business
• Work cross-functionally with DaVita and Non-DaVita operations leadership across chronic and hospital services teams to introduce Patient Pathways
• Provide coverage assistance at Patient Pathways partner hospitals as needed (including but not limited to covering during teammate PTO leave or position vacancies)
• Analyze Patient Pathways reports for assigned territory including but not limited to patient volume for each Dialysis Coordinator and length of stay and readmissions metrics for territory and individual hospitals
• Analyze performance of each market and make recommendations on future action plans based on the analysis
• Provide management team with monthly updates regarding the above metrics

Manager, Regional Operations

Counselor

• Provides education and guidance to DaVita patients about health insurance and the implications of different insurance options
• Conducts patient insurance education while operating within established compliance parameters of the company
• Identifies and effectively communicates opportunities to better the insurance status of the patient to help reduce or alleviate financial risk and burden
• Provides information to patients to help them find and/or secure options for insurance coverage and other financial assistance programs as necessary
• Completes insurance assessments/evaluations for patients to accurately document patient education sessions
• Acts as a liaison between patients, facility teammates, billing office and the corporate office to resolve patient insurance issues and/or concerns
• Builds and maintains relationships with field partners to ensure seamless patient support
• Provides monthly reporting and analysis on key metrics related to patient education and advocacy

Insurance Counselor I

Collections

• Provide daily supervision, direction, mentoring, coaching, and performance management to teammates
• Ensure high quality customer service according to department and company policy
• Monitor team productivity and progress of specific area job functions
• Lead or actively participate in special projects
• Perform root cause analysis on large amounts of datasets and create detailed reports for strategic business issues and opportunities
• Prepare and implement action plans and lead improvement initiatives
• Maintain reporting continuity, integrity, and communication among analytical departments

Supervisor, ROPS MS Collections

RN Case Manager – Advanced

• Research, initiate follow-up and resolve all health care insurance claim accounts with existing credit balances.
• Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of claims.
• Use critical and analytical problem solving skills to resolve issues.
• Utilizes excellent written and oral communication skills to collaborate and maintain positive working relationships with peers, leaders, clinical personnel, and payer representatives to resolve credit balances.
• Contributes to implementation of process improvement initiatives aimed at improving credit department.
• Supports monthly reporting of outstanding credit balances.

Specialist II, Credit Balance

• Process patient insurance information through the patient intake process
• Ensure timely and accurate submission of insurance claims
• Collect payment on outstanding patient balances
• Communicate with insurance payers for proper coverage and reimbursement
• Review and submit system setup requests for accurate billing
• Respond timely and accurately to payer communications
• Collaborate with revenue operations teams for seamless processes
• Maintain current patient account information and confidentiality

Revenue Specialist I

• Patients come first. You have an opportunity to build on your relationship with your patients, while also continuously improving their health through clinical goal setting and quality improvement initiatives.
• Meaningful Workday - EVERY Day. You'll go home every day knowing you are making a difference in patients' lives and that you are developing your team to reach their full potential.
• Lead a Team. Develop, mentor and inspire a cross-functional clinical team (census dependent on state laws) to deliver the best for our patients, teammates and community.
• Financial Management. Manage complete operation and performance of the clinic: adhere to budget, forecast expenses, manage vendor relationships, order supplies, and monitor compliance.
• Autonomy. It's your clinic to run. You aren't alone though. You will have the support and guidance of your director, regional peers and the greater company to help you manage your facility.
• We foster entrepreneurs and those who seek to continuously improve.
• Partner with Regional Operations Director to identify and address employee and patient concerns to drive towards Regional goals and standards.

Revenue Specialist III

Revenue Specialist II

Senior Manager, Payor Partnership

Revenue Specialist, III

RN Case Manager, Experienced

Revenue Specialist III

Director – IKC ConnectX Operations

Regional Operations Director

Manager, Regional Operations

Insurance Counselor I

Supervisor, ROPS MS Collections

RN Case Manager – Advanced

Specialist II, Credit Balance

Revenue Specialist I

Healthcare Operations Manager