Employment Type:
Full time
Shift:
Day Shift
Description:
The director leads and directs the work of the assigned Regional Health Ministry (RHM) Patient Access and Revenue Excellence functions.
POSITION PURPOSE
The director leads and directs the work of the assigned Regional Health Ministry (RHM) Patient Access and Revenue Excellence functions including: patient scheduling (as assigned), reception/check-in, switchboard, charge capture, data integrity, bed management, registration, financial counseling and revenue management support. The role motivates staff to achieve the highest levels of customer satisfaction and to meet the organization goals for customer service and financial performance. This position is charged with optimizing staff performance through process redesign, policy/procedure implementation, communications, and outcome feedback. The incumbent interacts with other departments within the Shared Services Center (SSC) as well as within the Regional Health Ministry (RHM), as required and serves as a representative of the department. They attend managerial meetings as required and support the core values of Trinity Health, which is an integral part of this position.
ESSENTIAL FUNCTIONS
Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in leadership behaviors, practices, and decisions.
Provides leadership for departmental services through collaboration with customers, associates, physicians, clinics, other internal departments and services, vendors, etc. Scope of job duties, include and are not limited to:
- Directly responsible for managing the intake functions of the assigned RHM Patient Access department(s). Manages/supports multiple supervisors with clerical staff working 24/7 to perform a variety of functions, including:
- RHM Patient Access: Patient Scheduling (if responsible), Reception/Check-In, Switchboard, Registration (IP Admission, Outpatient, Series, Emergency Department, etc.), Medical Necessity Review/Patient Admission Designation (if responsible), Medical Necessity (ABN Delivery), Point-of-Service Collections, Financial Counseling, Eligibility Assistance, Customer Service, and Cashiering; and
- Revenue Management Support: Quality Assurance and Training, Data Integrity, DNFB/Hold Maintenance, Pre-Bill Charge Audits, Pre-Bill Edits, Charge Capture, Late Charge Monitoring, Charge Description Master (CDM) Maintenance, Technical Denial Follow-Up, ITS Support and other related activities.
- Provides operational guidance and direction to assigned staff to ensure service integration, effective coordination of departmental work activities, and quality job performance;
- Participates in the redesign of registration and intake processes to improve service, data integrity, and staff productivity/quality to achieve departmental goals and process outcomes;
- Provides input and content expertise in the design and enhancement of the Patient Access Services/Registration computer systems and support processes;
- Represents the department in all matters directly relating to registration functions and in the absence of the Regional Manager/Regional Director or other management team members;
- Serves as primary liaison regarding registration and database issues; 3rd party reimbursement issues related to registration practices; charge entry, financial counseling; and assigned reception activities;
- Elicits feedback from interdisciplinary team, including the medical staff and involves them in decision-making, where applicable; and
- Responsible for tracking and improving processes on Key Performance Indicators such as wait times, staff productivity, quality, point of service collections, etc.
Educates physicians, physician office staff, and organizational leadership and associates regarding scheduling (as assigned), registration, bed management, medical necessity review, Point-of-Service collections, financial counseling, charge capture, eligibility assistance, customer service, and cashiering functions:
- Functions as a consultant to Regional Health Ministry Directors and leadership, physicians, case managers and others regarding Medicare, Medicaid, and commercial insurance guidelines for Patient Access Services;
- Serves as a primary liaison to members of the medical staff and other Regional Health Ministry colleagues regarding onsite Patient Access functions; and
- Meets with individual or groups of physicians, family members, 3rd party payers, and vendors as necessary in order to facilitate the patient access process.
Manages assigned colleagues in order to ensure steady workflow balance and high quality outcomes:
- Retains, interviews, recruits and is accountable for the on-going development and evaluation of individuals within the area of responsibility;
- Develops colleague work schedules to ensure cost effective staffing that meets customer requirements;
- Establishes, implements and evaluates on-going performance improvement programs, utilizing an interdisciplinary approach;
- Responsible for the financial and personnel management of assigned areas; and
- Effectively directs and facilitates a multidisciplinary team to achieve its desired outcomes.
Identifies action plans to improve the quality of services in a cost efficient manner and facilitates plan implementation.
Prepares required reports using statistically sound information, displaying content in easily understandable format.
Maintains professional development and growth through journals, professional affiliations, seminars, and workshops to keep abreast of trends in revenue cycle operations and healthcare in general:
- Participates as appropriate in continuing educational programs and activities that pertain to healthcare and revenue cycle management, as well as specific functional areas;
- Develops and implements an annual plan of personal and professional development; and
- Participates in local, regional and national health care revenue activities and professionally represents Trinity Health at these functions.
Serves in a leadership role and promotes positive Human Resource Management skills:
- Fosters teamwork atmosphere between business and clinical stakeholders;
- Retains, recruits and manages staff to achieve strategic objectives; and
- Provides staff training and mentoring.
Other duties as needed and assigned by the Regional Manager/Director or other Revenue Excellence Leadership, including but not limited to leading and conducting special projects. Develops project work plans, facilitates resource allocation, executes project tasks and obtains assistance from other intra and inter-Regional resources, as required.
Maintains a working knowledge of applicable Federal, State and local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
LEADERSHIP COMPETENCIES
As a Trinity Health Leader, the incumbent is expected to demonstrate leadership traits which support our Mission Statement and Core Values as identified below:
Mission Statement: We, Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities.
Core Values:
- Reverence: We honor the sacredness and dignity of every person.
- Commitment to Those who are Poor: We stand with and serve those who are poor, especially those most vulnerable.
- Justice: We foster right relationships to promote the common good, including sustainability of Earth.
- Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care.
- Integrity: We are faithful to those we say we are.
Hourly pay range: $44.4301 - $73.3097
MINIMUM QUALIFICATIONS
Must possess a demonstrated knowledge of Patient Access, Pre-Service and Revenue Management functions, as normally obtained through a Bachelor's degree in Healthcare or Business Administration, Nursing, or a related field, or an equivalent combination of years of education and experience. Minimum of three (3) years of experience managing functional areas of Registration, Pre-Service/Financial Clearance, Financial Counseling, Case Management/Utilization Review, or other management functions related to revenue cycle activities in a complex, multi-site environment.
Working knowledge of computer operations and electronic interfaces is required. Formal software course training is preferred. Certified Healthcare Access Manager (CHAM) as awarded by the National Association of Healthcare Access Management (NAHAM) or eligible candidate preferred.
Ability to lead and manage diverse staff in a learning environment with frequent changes in departmental priorities. Ability to recognize necessary changes in priority of tasks and allocation of resources, and act upon them as required ensuring workload balance.
Demonstrated ability to interpret 3rd party payer contract requirements and recommend, design and implement procedures for compliance with regulations and standards. Ability to negotiate with insurance vendors, medical directors, and 3rd party payers when appropriate in order to facilitate the delivery of care in the most appropriate setting.
Knowledge of Medical Necessity review guidelines (LMRP/LCD and SI/IS criteria) for commercial, Medicare, and Medicaid insurance products. Uses knowledge of insurance criteria and regulations in order to expedite appropriate use of resources and compliance with 3rd party payer contracts.
Ability to communicate and work with patients/guarantors, physicians, physician office personnel, colleagues, case managers, 3rd party payer review personnel, and others in order to expedite the patient access process to avoid negative financial and/or customer service impact on the facility. Dynamic communication skills (verbal and written) in dealing with trainees, associates, and internal/external customers. Serves as a change agent, coach, mentor, team builder and facilitator.
Must possess strong organizational and analytical skills in order to detect and resolve problem. Ability to address complex problems with multi-level impacts and with solutions not readily apparent. Uses sound judgment, in-depth analysis and expertise to resolve issues.
Ability to prioritize and deliver on key initiatives; demonstrated success in achievement of key performance metrics targets within time and budget constraints.
Exhibits superior management skills that emphasize team‑building and strong leadership with the ability to provide clear direction to the department, while also functioning as an individual contributor.
Ability to attract, develop, deploy and retain a world‑class revenue cycle team, capable of performing as a team and of evolving with the organization’s vision and with cutting‑edge technologies.
Displays a demonstrated understanding of project management, revenue cycle technology infrastructure and related issues.
Must be able to operate effectively in a collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
Must be able to adapt to frequently changing work priorities, and be able to prioritize and balance the requirements of working with the System Office and Regional Health Ministries (RHMs).
Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles.
Must be able to travel to the various Trinity Health sites (20%) as needed.
Must possess the ability to comply with Trinity Health policies and procedures.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
