Purchase Referred Care Director

Position Description

Purchase Referred Care Director Work location: 2960 Tongass Ave, Ketchikan, AK 99901 Salary Range $89,615.47 - $169,706.20 Salary/year Position Type Regular Full-Time Description Indian Preference in hiring is given to qualified enrolled members of Ketchikan Indian Community (KIC) and Native Americans consistent with P.L. 93-638 and in accordance with KIC policy and other applicable federal laws. The Purchased and Referred Care (PRC) Director is responsible for the management and oversight of the PRC department, ensuring efficient and effective utilization of resources to provide (through referral and PRC funding) comprehensive healthcare services to eligible American Indian and Alaska Native patients. This role includes planning, directing, and coordinating medical referral services, financial operations, and compliance with KIC Tribal Health Clinic and Indian Health Services (IHS) policies and federal regulations The director will provide leadership and guidance for establishing production and work flow systems, setting production and quality standards, defining all operating policies and procedures and claims processing guidelines, coordinating with other departments to ensure that claims payment functionality is optimized to achieve business, operations and reporting objectives, and assuring that goals are met. The director will also participate in Accreditation Association for Ambulatory Health Care (AAAHC) activities and have a complete understanding of CFR42, IHS and PRC regulation and KIC THC PRC policies and procedures.