Application Opening - Wednesday, October 12, 2022

**Interested applicants are encouraged to apply immediately as this job ad may close at any time but no sooner than October 26, 2022.**

This is a Position-Based Test conducted in accordance with Civil Service Rule 111A.

Compensation Range: $122,200 and $156,026 annually. For more details see
comp and class.

The Department of Public Health is accepting applications for a Denials and CDM Manager (0922 Manager I) within Patient Accounting.

POSITION DESCRIPTION:

Epic roles and responsibilities have brought a need for CDM/Denials Manager in the Revenue Integrity Unit. This position will perform planning, directing, and coordination in providing Epic technical support for all staff in the Revenue Integrity Unit and oversee and work with information technology to improve Epic programming for Epic charge reconciliation, charge review processes, WQs, and the charge description master (CDM), including validating implemented changes. The CDM and Denials Manager will participate and represent the Patient Accounting Department on committees as required, along with keeping policies and procedures current with Patient Accounting, ZSFG, and SFHN practices. The manager will create and implement a new Epic denial management program including, but not limited to, analyzing the outstanding denials, reporting the outstanding denials to various departments, and suggesting tactics that can be implemented as necessary to improve denial rates.

As with all management positions, this role will provide the necessary vision and leadership to effectively motivate and direct the staff they manage in the Patient Accounts Department in developing and achieving goals and objectives that are congruous with the values, mission, and strategic plan of the Zuckerberg San Francisco General Hospital, the Department of Public Health, and the San Francisco Health Network which requires valuing diversity as demonstrated by inclusive behavior including in communications with patients and residents, co-workers, and the public.

ESSENTIAL DUTIES:

The Denials and CDM Manager (0922 Manager I) performs the following essential job functions:

1. Create and review weekly/monthly denial reports to promptly identify trends in new denials received and create action plans for Departments to reduce/eliminate denials.
2. Interact with all DPH departments (Health Information Management Systems, clinics, providers, and so forth) through MS Teams, Webex, phone, and in-person as required.
3. Make recommendations to Patient Accounts management and collaborate to determine/design denial management tactics that will effectively decrease denial rates and/or eliminate specific denials.
4. Plan, organize, and direct staff on CDM maintenance and follow-up functions on denial research and resolution.
5. Attend and represent Patient Accounting at various meetings such as Compliance, Zuckerberg San Francisco General Hospital, Community-Oriented Primary Care Clinics, and Laguna Honda Hospital department leaders.
6. Manage staff within Denials/CDM and assist with Revenue Integrity staff oversight.

The Denials and CDM Manager (0922 Manager I) performs other duties as required and assigned.

MINIMUM QUALIFICATIONS (all candidates must verify that they meet all elements below—education and experience including type and location):

1.  EDUCATION: Possession of a bachelor’s degree from an accredited college or university;

AND

2. EXPERIENCE: Three (3) years of verifiable administrative work experience in a patient accounting or business office of an acute care or long-term care hospital or healthcare clinic of which two (2) years must be in medical billing or accounts receivable management.

Education substitution: Additional experience as described above may be substituted for the required degree on a year-for-year basis (e.g., four (4) additional years of experience as described above may substitute for a bachelor's degree OR two (2) or three (3) additional years of experience and possession of an associate of arts (AA) degree or equivalent can substitute for the bachelor's degree). One (1) year is equivalent to thirty (30) semester or forty-five (45) quarter units); completion of sixty (60) semester or ninety (90) quarter units is equivalent to an AA degree.

Note: One year of full-time employment is equivalent to 2,000 hours of qualifying work experience (one year if performed full-time at 40 hours per week). Any overtime hours that were worked above 40 hours per week are not included in the calculation to determine qualifying hours worked.

Applicants must meet the minimum qualification requirements by the final filing date unless otherwise noted.

Desired Qualifications:
The stated desired qualifications listed below may be used to identify job finalists at the end of the selection process after candidates are referred for selection.

• Current Certified Medical Coder Certification issued by AAPC (American Association of Professional Coders) or AHIMA (American Health Information Management Association)
• Two (2) years of supervisory experience
• Knowledge of the Epic electronic medical records system

Note: Falsifying one's education, training, or work experience or attempted deception on the application may result in disqualification for this and future job opportunities with the City and County of San Francisco.

Verification of Education
Verification of Experience

SELECTION PROCEDURES

Minimum Qualification Supplemental Questionnaire (MQSQ) (Weight: Qualifying): Applicants will be required to complete a Minimum Qualification Supplemental Questionnaire by email after your submit your application. This MQSQ is designed to obtain specific information regarding an applicant's experience in relation to the Minimum Qualifications for this position. Applicants must also complete the official application. It is essential that applicants provide complete information identifying their education, experience, and training. The MQSQ will be used to evaluate if the applicant possesses the required minimum qualifications.

Supervisory Test Battery (Weight: 40%): Candidates will be invited to participate in a computer-based examination designed to measure competencies in job-related areas which may include but not be limited to: Problem Solving; Leadership; Decision Making; Interpersonal skill; Human Resource Management; Team Building; Communication, Conflict Management and Process Improvement. For more information about this Supervisory Test (and a suggested reading list) please visit Supervisory Test Battery info Please note: this examination is only held in San Francisco. A passing score must be achieved on the Supervisory Test Battery to continue in the selection process. This is a standardized examination and, therefore, test questions and answers are not available for public inspection or review. Scores attained on the Supervisory Test Battery will be valid and 'banked' for three years, starting from the date of the examination. This means that, during this three-year time period, you will not be required to take the Supervisory Test Battery. The Supervisory Test Battery may be used for many other classes; therefore, your test score may be applied to one or more of these classes if you choose to apply to future recruitments. If the selection process for the future announcement is held within one year of the date of this examination and it includes the Supervisory Test Battery, your score will be automatically applied to that announcement. However, after one year, you have the option to either (a) apply your test score to the other announcement or (b) re-take the Supervisory Test Battery. Retesting is permitted no sooner than one year from the date of the examination and only in association with your eligibility for another announcement for which the Supervisory Test Battery is used. Please note that, should you re-test, your re-test score would become your official score since it is the most recent.  

Supplemental Questionnaire (SQ) Examination (Weight: 60%): Candidates who achieve a passing score on the Supervisory Test Battery (STB) will be emailed a Supplemental Questionnaire (SQ) that is designed to measure the knowledge, skills, and abilities in job related areas which may include but not be limited to ability to interpret and operationalize reimbursement guidelines including Medicare, Medi-cal (including managed care) and commercial payers, ability to drill down and analyze claims and denials data to continuously lower denial rates for Medicare/Medi-cal (including managed care) and third-party billing by providing actionable reports to managers and supervisors, skills in collaborating and gaining buy-in to make necessary changes to reduce denial rates, including the ability to work through resistance to change amongst peers and senior managers. The SQ link will be emailed to the address listed on the candidate’s online application. Candidates will be required to respond to the SQ in the time frame indicated and must submit the completed questionnaire as directed in order to have it evaluated. Responses cannot be changed once submitted. Candidates will be evaluated based on their SQ responses. Candidates must achieve a passing score on the SQ in order to continue in the selection process and will be placed on the confidential eligible list in rank order according to their final score. A passing score must be achieved on each of the above-described exams in order to be included on the confidential eligible list. After the confidential eligible list is adopted the department may administer additional selection procedures to make a final hiring decision.  

Eligible List/Score Report: 
A confidential eligible list of applicant names that have passed the civil service examination process will be created and used for certification purposes only. The duration of the eligible list resulting from this examination process will be of six (6) months and may be extended with the approval of the Human Resources Program Director. 

Certification: The certification rule for the eligible list resulting from this examination will be Rule of the List. Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.

Exam Type: Combined Promotive and Entrance (CPE)

Confidentiality: All personal information will be kept confidential according to EEO guidelines.

Licensure/Certification/Registration: Valid, unrestricted licensure/certification/registration as a requirement to perform this job must be kept current throughout length of employment. Failure to demonstrate/show proof of possession of required valid licensure/certification/registration may result in dismissal and/or termination of employment.

Note on Electronic Health Record (EHR): The Department of Public Health (DPH) is implementing a unified Electronic Health Record (EHR) system and DPH employees must demonstrate competency in the use of the system that is appropriate for their classification as a condition of employment. Note on  

Personal Protective Equipment (PPE): Some positions in the Department of Public Health will require the use of personal protective equipment (PPE), including but not limited to gloves, gowns, eye and face protection, and face-fitting respirators. The requirement for the use of PPE may come on short or no notice. Facial hair or any condition that interferes with a face-fitting respirator’s seal (i.e. comes between the sealing surfaces of the respirator and the wearer’s bare skin) is not permitted when face-fitting respirators are worn, including during initial or periodic respirator fit-testing. Employees who choose not to shave and do not have either American Disabilities Act (ADA) or Equal Employment Opportunity (EEO) Accommodations do not have the right to alternate work assignments or the option of using a loose-fitting Powered Air Purifying Respirator (PAPR) in place of a Face Fitting Respirator.  

Medical Examination/Drug Testing:
Prior to appointment, at the Department's expense, applicants may be required to take a tuberculosis (TB) screening test, a medical examination and/or drug test.

Terms of Announcement:
Applicants must be guided solely by the provisions of this announcement, including requirements, time periods and other particulars, except when superseded by federal, state or local laws, rules or regulations. Clerical errors may be corrected by the posting the correction on the Department of Human Resources website. The terms of this announcement may be appealed under Civil Service Rule 111A.35.1. 

Equity, Diversity, and Inclusion:
All employees are required to participate in the Department of Public Health's work in equity, diversity, and inclusion through:

• Commitment to providing first-class care and service to all members of the DPH service population, with heightened sensitivity and awareness to racial, ethnic, and culturally diverse members of the DPH’s workforce and patient populations.
• Desire and commitment to lead and participate in antiracism, racial justice, and equity work that impacts quality of patient care, and improvements in employee experiences; along with the commitment and fortitude to push and drive change in these areas.
• Desire to work with, relate to, serve, and support a diverse workforce and patient population.
• Commitment to health equity with a specific lens and focus on race, ethnicity, gender, sex, and sexuality.

Other useful information:

• Conviction History
• Benefits Overview
• Disaster Service Workers
• General Information concerning City and County of San Francisco Employment Policies and Procedures
• Information on requesting a reasonable ADA Accommodation
• Veteran's Preference
• Seniority Credit in Promotional Exams
• Copies of Application Documents\
• Right to Work

Exam Analyst
Beata Chapman
[email protected]
415-544-2912
/01126408

CONDITION OF EMPLOYMENT:  All City and County of San Francisco employees are required to be fully vaccinated against COVID-19 as a condition of employment. Someone is fully vaccinated when 14 days have passed since they received the final dose of a two-shot vaccine or a dose of a one-shot vaccine. Any new hire must present proof of full vaccination status to be appointed. Any new hire who will be routinely assigned or occasionally enter High-Risk Settings, must provide proof of having received a COVID-19 booster vaccine by March 1, 2022, or once eligible.

The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.