Division Director of Denial Prevention

Position Overview

This position is incentive eligible. Join HCA Healthcare as a Division Director of Denial Prevention, where you’ll provide direction and oversight for denial prevention initiatives within the West Florida Division. As part of one of the nation’s leading healthcare organizations operating over 180 hospitals and numerous care sites, you will work alongside passionate leaders to shape patient care and drive operational excellence.

Key Responsibilities

• Assist with identifying strategies for denial prevention and initiate processes for avoidance.
• Monitor and analyze trends within the non-governmental & governmental sectors.
• Support hospitals with root cause analysis of denials.
• Direct hospitals in developing and implementing corrective action plans.
• Identify education opportunities across division hospitals and assist the Shared Services Center with communication regarding appeals, CIV, NOA, and hospital PADs.
• Oversee weekly monitoring, dashboard development, and review.
• Interact with payers, physicians, and leadership teams to resolve issues and develop solutions.
• Maintain a current working knowledge of URAC Guidelines, credentialing, InterQual Criteria, and the revenue cycle.
• Be results oriented in all aspects of the role.

Required Qualifications

• Bachelor’s degree required.
• Must be a Registered Nurse or Certified Professional Coder (CPC).
• Experience in denial/appeal management required.
• Minimum of 2 years of managerial experience required.
• Strong analytical skills.
• Excellent communication skills and a customer service orientation.

Benefits & Perks

• Comprehensive medical coverage including prescription drug, behavioral health, telemedicine services, and free AirMed transportation.
• Dental and vision benefits, life and disability coverage with flexible spending accounts and supplemental health protection plans.
• Free counseling services for emotional, physical, and financial wellbeing.
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service).
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock.
• Family support benefits including fertility, family building, and adoption assistance.
• Referral services for child, elder, and pet care, as well as home and auto repair.
• Consumer discounts through Abenity and Consumer Discounts.
• Retirement readiness and rollover assistance services.
• Education assistance including tuition, student loan, certification support, and dependent scholarships.
• Colleague recognition program to celebrate achievements.
• Time Away From Work Program featuring paid time off, paid family leave, and long- and short-term disability coverage.
• Employee Health Assistance Fund offering free employee-only coverage based on income eligibility.