Director of Revenue Cycle Patient Access

2 weeks ago


Providence, United States Care New England Health System Full time

Job Summary:

Responsible for overseeing operations related to the Centralized Scheduling, Centralized Notification and Authorization (NoVA), Financial Counseling departments, and Patient Referrals and Authorizations for practices within the Care New England Health System. Establishing and monitoring staff performance metrics, as well as setting expectations with management. Ensuring adherence to organizational policies. Updating and creating policies and procedures, as the needs are identified, that will outline best practices and provide workflow guidance.

The position will partner with clinical departments to scope and manage aspects of Patient Access across Care New England including, the patient scheduling, patient referrals, insurance verification, insurance authorization and financial counseling strategy needs for any new service lines or locations.

Identifying patient access issues and escalating with resolution resources efficiently. Engaging with patients as needed for escalated patient concerns or complaints surrounding experiences with the Access Center functions. Managing department budgets and tracking staff OT outliers.

Creating a collaborative environment, where department needs are met, access goals are achieved, and quality is delivered. Establish strong and consistent communication pathways surrounding workflow, projects and issues/resolutions.

Duties and Responsibilities:

Responsible across all CNE entities for ensuring that Federal and State regulations are adhered to.

Oversee management of computerized scheduling system to appropriately schedule inpatient and outpatient ancillary department testing, surgical and other procedures, practice appointments, as well as coordinate pre-admission services allowing for maximum utilization of department and practice services across the Care New England Health System

Oversees central scheduling coordinator and team leads communication with physicians, department staff, practice staff, or patients to resolve scheduling conflicts and/or overcome any scheduling barriers that may result in delays.

Manage all activities of the departments by providing leadership and serving as a resource to evaluate and identify strategies for problem solving.

Promotes system-wide standardization and identification of best practices for assigned areas of responsibility.

Collaboration with other areas within the Revenue Cycle Division to ensure patients are directed to appropriate resources.

Overall responsibility for planning, staffing, managing and evaluating all systems applications activities of the revenue cycle for the CNE Hospitals.

Identifies information and system needs across the CNE Hospitals to assure the technology meets procedural changes, third party payer requirements, and government regulations.

Maintains a thorough knowledge of contract terms for all payers for all CNE facilities.

Proactively oversees the operation and effectiveness of various activities system wide ensuring that departmental metrics are being achieved.

Preserves and protects patient's rights to confidentiality.

Performs other related duties as requested.

Requirements:

Bachelor's degree required

Minimum of 5 to 7 years management experience in revenue cycle or acute healthcare environment or equivalent combination of education and experience.

Excellent interpersonal, oral, and written skills required. Ability to manage multiple systems and processes and to work between clinical, operational and financial areas required.



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