Job Details

Job Summary:

This position is accountable for extending the administrative capacity of the Durable Medical Equipment (DME) Manager by assuming responsibility for day-to-day functions such as schedules, staffing, work-flow monitoring and assignments, training, metrics monitoring and measuring, etc. This work will be done in addition to providing the full line of DME products and services to Kaiser Permanente Health Plan members as covered by the DME benefit, including prosthetics, orthotics, DME equipment and supplies, enteral, nutrition, and oxygen. The role also involves acting as a resource for physicians, clinicians, health plan members, and vendors throughout the region, ensuring orders comply with local, state, and federal guidelines, billing instructions, limitations, and benefit eligibility. The position works under the indirect supervision of the DME Manager, supporting the mission of the Northwest Region and the organization's funds in administering the DME benefit.

Essential Responsibilities:

• Represent functions of DME Benefit Coordinator II depending on work volume and demands of lead duties.
• Schedule staffing for all employees within the department; approve time off requests and ensure appropriate staffing levels. Create or adjust team work schedules. Ensure employees maintain appropriate work schedules. Address employee issues in the absence of the department manager.
• Orient, train, counsel, and evaluate employees according to department performance standards. Prioritize workflow, monitor employee progress, performance, and productivity. Resolve work group process issues; chair or facilitate DME at committee meetings. Collaborate with the manager to improve work processes and ensure regulatory compliance.
• Ensure customer satisfaction by providing fast, reliable, courteous, auditable, and appropriate service. Handle escalated cases related to internal and external customer service. Serve as a resource; provide information on products, services, and processes.
• Manage costs through effective utilization review of requested equipment. Use databases and reporting tools to ensure compliance and timeliness. Determine actions and assign responsibilities for remediation. Perform audit follow-up and communicate with vendors as needed.
• Resource Management: Audit DME systems and data proactively to identify unusual expenses, utilization patterns, trends, or flags warranting investigation. Identify cost-saving or cost-avoidance opportunities. Perform root cause analysis and recommend resolutions. Analyze performance data to validate operational assumptions or identify shifts affecting costs or compliance. Develop, review, update, and maintain policies and procedures related to DME. Educate and train employees on these policies.
• Project Management: Serve as the department liaison for NW region initiatives. Represent DME operations and regulatory issues, participate in designing, developing, and implementing new systems, communicate with DME staff, and collaborate across departments.
• Perform other duties as assigned by supervisory personnel consistent with the individual's training and experience.