Director-Consumer Access

All the benefits and perks you need for you and your family:

· Benefits from Day One for FT/PT positions

· Paid Time Off from Day One for FT/PT positions

· Paid Parental Leave for FT/PT positions

· Student Loan Repayment Program for FT/PT positions

· Career Development

· Whole Person Wellbeing Resources

· Mental Health Resources and Support

· Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense)

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

GENERAL SUMMARY:

Consumer Access Regional Director serves as the market leader integrating practices in coordination with clinical executives, facility executive leadership, and revenue management executives. Reporting to the Consumer Access Executive Director, directs operational oversight as the subject matter expert in the delivery of all Consumer Access services in the market to ensure consumer centric, results-oriented performance in alignment with the mission and vision of AdventHealth. Provide strategic leadership of patient registration, quality assurance, time of service collections, and consumer services in multiple departments across facilities within the market as the subject matter expert in a multi-disciplinary approach to all Consumer Access services. Articulate clear ongoing communication and proactively engages in problem resolutions for patients, physicians, administration, and other internal or external customers including serving as a market liaison to facilitate discussions and questions regarding Consumer Access processes, performance improvement directives and upfront avoidable claims reimbursement issues. Performs administrative or leadership duties in the absence of the Executive Director. Identifies latent skills in staff and provides opportunities for personal and professional development. Actively participates in providing outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. This position may require occasional travel. Adheres to AdventHealth Compliance Plan and to all rules and regulations of all applicable local, state, and federal agencies and accrediting bodies.

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:

Scope of Responsibility:

· Reporting to the Consumer Access Executive Director, directs operational oversight as the subject matter expert in the delivery of all Consumer Access services in the market to ensure consumer centric, results-oriented performance in alignment with the mission and vision of AdventHealth.

· Provide strategic leadership of patient registration, quality assurance, time of service collections, and consumer services in multiple departments across facilities within the market as the subject matter expert in a multi-disciplinary approach to all Consumer Access services.

· Works closely with Access, PFS and Revenue Integrity reviewing clinical information and departmental policies and practices to ensure team and departmental goals are in direct alignment with organizational initiatives and objectives established by Executive Access leadership.

· Assesses and understands business processes of the Revenue Cycle. Anticipates needs of the assigned departments and pursues solutions. Displays extensive knowledge of information system technologies and internal systems to ensure optimum efficiency in Department’s operations. Oversees the testing and performance functionality of programs in accordance with department policies.

· Attends departmental, interdepartmental and facility level leadership meetings, facilitating as requested by Executive Access leadership.

· Liaises with campus partners (both clinical and non-clinical) to ensure effective communication of all Consumer Access processes.

· Provides direction to direct reports, ensuring Revenue Cycle performance metrics are achieved consistently.

· Demonstrates effective oral and written communication skills; maintains required level of confidentiality; interacts effectively with employees at all levels.

· Responsible to be on call as necessary for departmental emergencies and assistance.

Compliance/Regulatory Responsibility:

· Ensures all patient accounts are created, verified, authorized and/or preregistered in timely manner with appropriate follow up for account completion and up-front collection in all registration areas.

· Ensures full compliance with team protocols to minimize avoidable denials from payers and accuracy of Consumer Access functions including but not limited to insurance verification, authorization, and referrals.

· Ensures efficiency in patient registration operations, as required, to avoid delays in patient care. Collaborates with clinical leadership and direct reports to ensure frontline team is up to date on process changes, technology drivers, and initiatives.

· Ensures assigned personnel are knowledgeable of and comply with hospital and department policies and procedures and with all applicable federal, state, local and accrediting bodies’ rules, regulations, statues, requirements and standards. This includes MSPQ, EMTALA, AHCA, TJC, CMS, OIG, HIPAA and any State or Federal compliance regulations for Healthcare Organizations.

· Directs the management staff of the Consumer Access Department in order to ensure training programs for new and existing staff continue to meet all state and government regulatory requirements.

· Reviews and researches government regulations, analyzing effects on department operations. Communicate changes appropriately and efficiently. Develops plans of action with division and regional leadership, as needed.

· Provide oversight and coordination with the Risk Management Department in the identification of risks, analysis of the causes of incidents and investigation of incidents as may be required for legal purposes. Works with Risk Management Department in developing corrective action plans addressing noted trends or categories of risks/incidents.

· Accountable to all departments, service partners and clinical offices for the performance of the market Consumer Access department and serves as point of contact along with Executive Access leadership for any unresolved issues or those requiring service recovery measures.

· Maintains knowledge of medical terminology, pre-admission, authorization, verification, insurance, medical necessity, reimbursement contracts and departmental and system policies and procedures.

Operating & Capital Budget/Financial Responsibility:

· Meets monthly budget goals by managing staff levels that are within set labor standards and limiting use of overtime for Consumer Access in order to offer prompt patient service. Regularly reviews monthly budget and volume reports. Limits use of overtime by monitoring productivity. Ensures employee performance and attendance documentation is current and accurate.

· Monitors staffing levels to maintain performance and contribute toward departments key performance indicators while meeting budgetary constraints.

· Works with market and corporate leadership to develop strategies across areas of responsibility to maximize accuracy of estimation of patient responsibility and increase upfront collections.

· Develop strategies across cross functional departments to exceed revenue management cash projection and reduce days in accounts receivable and denials.

· Provide input and improvement strategies while actively participating in denial management optimization meetings.

Strategic Planning Responsibility:

· Strategically designs the Patient Access process to meet or exceed key performance indicators as identified by AdventHealth Corporate, related to financial metrics, regulatory compliance requirements and patient experience initiatives.

· Translate strategies into operational plans to deploy all strategies across systems. Assists in the annual review and updating of all policies and Standard Operating Procedures pertinent to areas of responsibility.

· Supports Executive Access leadership in the development of departmental strategic plans by defining projects, priorities, and actively involved in ROI/EVA analysis, quality assurance plan, accrediting agencies and internal audit plans.

· Meets with Executive Director Consumer Access/Revenue Cycle Leadership to review key indicators addressing any areas of concern and plans for resolution.

· Ensure that cross-departmental operations are optimized and aligned within revenue cycle operations by meeting with Executive leadership to review key indicators addressing any areas of concern and plans for resolution.

· Analyzes the impact of environmental changes in managed care, health care reform, and government payment systems on operations.

· Develop strategies to reduce cost to collect across functional departments

· Be the primary business champion for new technology implementations within the revenue management team by taking part of clinical and financial teams formed to implement new software or procedures designed to correctly and timely collect reimbursement. Ensures communication flows consistently and timely to ensure protection of our organization’s financial standing.

Performance Improvement Responsibility:

· Responds with agility to change and proactively investigates process and performance strategies using patient and account data and trends to drive improvement. Actively seek new and improved ways to increase productivity and overall SLAs for Consumer Access.

· Articulate clear ongoing communication and proactively engages in problem resolutions for patients, physicians, administration, and other internal or external customers including serving as a market liaison to facilitate discussions and questions regarding Consumer Access processes, performance improvement directives and upfront avoidable claims reimbursement issues.

· Reviews all collection reports available, communicates outcomes to team and leadership timely, and provides accurate statistical records and reports. Holds self and staff accountable for individual and team goals set by Revenue Cycle and AdventHealth leadership.

· Meets regularly with Executive leadership, both facility and corporate to review department key performance scorecard indicators and improvement initiatives.

· Provides ongoing education to minimize errors and avoid denials and rejections to direct reports. Works with pre-access and revenue cycle leaders to strategize and continuously research for the prevention of consumer access related denials. Identifies root causes of no authorization denials and works with direct reports to resolve process gaps as well as collaborates with other departments to educate as necessary to minimize denials.

· Cultivates leadership development by providing ongoing feedback to team members, management staff, and/or leadership.

· Focuses on process improvement strategies with special focus on up-front cash collections outcomes to protect financial standing of hospital

· Continuously evaluates department processes to maintain efficiency and effectiveness always being open to and searching for opportunities to provide excellent service

Community Relations Responsibility:

· Ensures full effort of the consumer-centric focus by providing excellent customer service to our patients in dealing with complaints, estimate discrepancies, etc.

· Works closely with market leadership and administration on various service initiatives to fulfill business plan requirements related to service that may be established by Executive Access leadership.

· Adheres to department operation procedures for response to external disaster protocols. Responsible to be on call as necessary for departmental emergencies and assistance.

· Advocates team involvement of the Hospital approved community programs, including Heart Association’s Heart Walk, and United Way.

· Accountable for optimal system patient satisfaction scores across AdventHealth campuses, ensuring they meet or exceed hospital standards.

Staffing/Labor/Supervisory Responsibility:

· Provides staff with resources, tools and training necessary to achieve performance standards including accuracy, timeliness, collections, minimizing denials and rejections and other metrics that may be established by Executive Access leadership.

· Ensure cascading of all senior leadership messages. Stays up to date with Access initiatives. Serves as a resource regarding interdepartmental and payor questions, providing educational feedback as needed.

· Reviews employee files and communicates written and verbal directions to employees with their managers to ensure well-informed status in performance of their job requirements as indicated. Evaluates disciplinary documentation and action plans developed by team leaders to ensure fair and consistent application of policies to all employees according to policies and procedures established by AdventhHealth Human Resources department

· Develop and review Consumer Access scorecards with directors, addressing any areas of concern and provide any required resolution. Acts as a leadership resource for management and team to achieve department specific and organizational goals, and score cards. Creates action plans to achieve positive outcomes.

· Delegate decision-making to allow further development of the next level of staff, involve directors in making cross-departmental decisions. Regularly meets with and mentor’s direct reports, providing guidance in day to day management of staff encouraging open, clear, and frequent communication.

· Maximizes patient capture and retention rates by strategically re-engineering consumer access processes to improve the consumer experience, increase patient volumes, and retain current patients by expanding access.

· Ensures timely completion of performance excellence evaluations and consistency in application of departmental policies, including those specifically dealing with progressive discipline. Evaluates and disciplines employees according to guidelines established within department and Human Resources Department.

Qualifications

KNOWLEDGE AND SKILLS REQUIRED:

· Must have a command of current medical terminology and significant experience with standard office equipment and computer office automation applications (i.e. MS Word, Excel, Power Point, and Outlook etc.)

· Must have advanced knowledge of, and experience with, registration and scheduling processes and software modules supporting these functions

· Strong organization and leadership skills and results-oriented; Proficient in time management with superior prioritization skills

· Effective oral and written communication skills, with the ability to articulate complex information in understandable terms to all levels of staff

· Ability to work in a matrix-management environment to achieve organizational goals

· Maintain a detail-level working knowledge of Government, State and Federal regulations and requirements, as well as contractual authorization/pre-certification guidelines/requirements. This includes maintaining a current knowledge and understanding of the following organizations, publications, bulletins and memorandums: Medicare Part A & B, Agency for Health Care Administration, Federal Register HCFA Notices and Updates, State Medicaid Program, Fair Debt & Collection Act Consumer Credit Act, Hospital HMO/PPO Contractual authorization/pre-certification guidelines/requirements, CMS, EMTALA, and HIPAA

· Inspires high performance and fosters a climate of collaboration and coaches effectively

· Initiates creative approaches to solving problems or tapping potential

· Must be able to read, write and speak conversational English

· Ability to follow complex instructions and procedures, with a close attention to detail

· Advanced understanding of insurance knowledge and benefits and hospital electronic medical report (EMR) system

KNOWLEDGE AND SKILLS PREFERRED :

· Working intermediate knowledge of patient accounting systems as well as back-end front-end revenue cycle functions and processes

· Bilingual – English/Spanish

EDUCATION AND EXPERIENCE REQUIRED:

· Minimum bachelor’s degree in Business Administration, Health Services Administration, Hospitality Administration, or related field (clinical disciplines, health information management, communications, finance, accounting, public administration, human resources, management, or marketing) OR

· Eight (8) years’ experience in Patient Access Department (central scheduling, insurance verification, financial clearance and pre-registration area) or related area

· Three (3) years’ experience in leadership role

EDUCATION AND EXPERIENCE PREFERRED:

· Master’s degree in Health Services Administration, Business Administration, or related field

· Seven years’ experience in Patient Access/Patient Financial Services or related area

LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:

· N/A

LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:

· Certified Healthcare Access Manager (CHAM)

· Certified Patient Account Manager (CPAM)

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

Category: Patient Financial Services

Organization: UChicago Medicine AdventHealth Great Lakes

Schedule: Full-time

Shift: 1 - Day

Req ID: 24042674

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.