OPERATIONS MGR, PATIENT ACCESS

Company: Mass General Brigham
Location: Wellesley
Posted on: September 27, 2024

Job Description:

DescriptionUnder the guidance of the Patient Access Director, the Operation Manager of Patient Access is responsible for the overall direction and management of the insurance verification, prior authorization, central scheduling and financial counseling functions for Patient Access Services. Responsible for implementation of system strategy to improve outcomes, reduce denials and increase collections, in coordination with the entire Patient Access Services department. He/ She ensures that financial clearance services are delivered per organization standards. This includes establishing standards and financial clearance metrics used to track and monitor the efficiency, quality and adherence of adopted policies and procedures. -Responsible for the day to day operations of the Central Authorization unit, denials, Huron worklists with a focus on outpatient and inpatient payer authorizations for multi-specialty services. - Overseeing scheduling, coordinates all operational activities in the Central Scheduling department, including ACD telephone system to support call center structure, regulatory requirements and quality improvement. - Also responsible for all scheduling activity, maintaining schedule templates for supported areas, while working collaboratively with all customers; physicians, patients, offices, and department managers/supervisors while providing a high level of service. - - - - - - - Effectively leads and coordinates initiatives and operations with hospital leadership, ambulatory care leadership, and other leadership representatives from various departments associated with the Financial Clearance tower. - - - - - - - Establish and set expectations and develops a system of accountability that aligns with the Financial Clearance strategic goals and operational initiatives. - - - - - - - - Directs and coaches' staff and relevant non-staff members to comply with Patient Access Services policies and procedures, ensuring efficient, effective personnel and operational management utilizing accepted bench marking standards. Partners with operational departments and leaders to promote continuous improvement in prior authorization, cash collections, denial reduction/elimination, bed debt reduction, and customer experience. - - - - - - - Direct efforts to institute summary level dashboards that serve to aggregate key performance indicators within the Financial Clearance Center to drive informed decisions regarding current state process, staff training/development needs, process improvement opportunities. - - - - - - - - Involved in patient access activities for inpatient and outpatient services, including insurance verification, authorization, referral management, notification, and denial mitigation. Investigates denials, analyzes for root cause, and creates action plan with Director. - - - - - - - Work collaboratively with central scheduling to educate patient and reschedule elective service as necessary. - - - - - - - Implements all departmental scheduling policies in compliance with regulatory and accreditation agencies. - Assists in changing or updating as needed. - - - - - - - Interacts with hospital departments and physicians regarding appointment availability. - - - - - - - Provides statistical reports, updates and data regarding utilization, appointment availability and no-show information on a regular basis and when requested. - - - - - - - Works in close collaboration with clinical caregivers utilizing agreed upon protocols and guidelines to correctly book as requested. - - - - - - - Maintains and updates all confirmation letters used in the departments as needed. - Ensures letters are generated and sent out timely. - - - - - - - Educate and train schedulers impacts of registration, insurance and revenue cycle to enhance their role in an integrated format within patient access. - - - - - - - Support and educate scheduling and registration as one job function to support direct scheduling with all physician offices. - - - - - - - Manages human resources activities for direct reports regarding recruiting, professional development, mentoring, counseling, performance evaluations.QualificationsEducation - - - - - - - Bachelor's degree preferred. Experience - - - - - - - 3-5 years of progressive leadership experience in an acute healthcare facility required. - - - - - - - 5 years of experience in Patient Access Services required, preferably in financial clearance and central schedulingLicense and Registration - - - - - - - N/AKnowdelge and Skills - - - - - - - Must be detail-oriented and organized, with good analytical and problem-solving ability. - - - - - - - Notable client service, communication, presentation and relationship building skills required. - - - - - - - Ability to function independently and as a team player in a fast-paced environment required. - - - - - - - Must have strong written and verbal communication skills. - - - - - - - Outstanding interpersonal skills, physician relations experience required. - - - - - - - Demonstrated Program and Policy development a must. Outstanding PC and information systems literacy required. - - - - - - - Demonstrated ability to use PCs, Microsoft Office, and general office equipment required.Job Field: Professional/ManagerialOrganization: Newton-Wellesley Hospital(NWH)Schedule: Full-timeShift: Day JobEmployee Status: Regular

Keywords: Mass General Brigham, Boston , OPERATIONS MGR, PATIENT ACCESS, Other , Wellesley, Massachusetts