Sutter Health Financial Clearance and Counseling Lead (Manager) - Patient Access/Roseville in Roseville, California
Manages, controls, directs and oversees patient pre-registration, financial counseling and clearance operations for scheduled services for all 26 hospitals in the Sutter Health Hospital System Manages team leads, provides oversight into all Patient Access functions and drives strategic direction, goals and objectives. Creates a culture of Patient Centered Care and Customer Service, consistent with the Sutter Health's Mission, Values and Vision. Oversees Financial Clearance and Counseling functions 24/7 365 day a year Patient Access activities across the system.
Leads the transformational change at Sutter Health in support of the Shared Services organization by completely redesigning how work is done today. This includes redesigning all workflows, job descriptions, implementing new software applications, performing gap analysis between Regions and working with the Lead of Patient Access to ensure consistent processes across Sutter Health. This involves the day to day interaction with the Leads, VP and Sr VP of SSS to ensure maximum efficiency within the organization while maintaining or developing strategies to reduce costs from the annual budget. Identifis and assists with the mitigation of the variances in the current Epic installations as they relate to Patient Access and help redesign standardized single processes across the entire Sutter Health hospital system of 26 hospitals.
Collaborates with staff and leadership within the organization including individual department directors in Hospitals, physicians, clinical staff and works with Sutter Executive Management to strategize and solve complex problems related to Patient Access to drive standard processes and ensure consistency of practices as well as continuous process improvement within the Patient Access arena. Recognizes cross functional interdependencies of decisions. Provides more complex analysis, advice and coaching in response to business issues and executes appropriate shared services Patient Access strategy. Makes decisions in fast-paced, fluid environment where limited precedents exist; actively collaborates with key business and functional partners accurately and within defined service level agreements.
Must have an "out of the box" thinking process that enables use of outside industry tools and applications to improve and enhance the patient experience and provide our physician partners and department partners with the enhancements. This requires a Lean focus in terms of process improvement for all aspects of the Patient Access Center.
Supports the success of a high-performing shared services organization by helping to champion and drive the long-term Sutter Shared Services vision. Helps foster an environment in which continuous improvement in business processes and services is welcomed and recognized. Participates in programs and in using tools in support of building a high performance culture via the standard Sutter Shared Services responsibilities (e.g. performance measurement, people development, customer relationship management, etc.).
Education, Licensures, and Certifications:
• Bachelor's degree Or equivalent education/experience required.
• Master's degree, MBA, MHA, or MHSA Or equivalent education/experience preferred
• Certified Healthcare Access Manager – CHAM preferred
• Demonstrated leadership experience and a proven track record in hospital registration management in a facility of significant size and complexity, hospital business operations and patient accounting applications, as typically acquired in more than 10 years of experience required
• Experience executing Patient Access standards, processes, policies, procedures and service level agreements required
• Experience in complex regional/ shared service Patient Access environment with multiple/ matrix reporting relationships required
• Experience managing complex/ large scale/ transformational projects, including demonstrated success in coordinating major projects and implementation of successful cost containment initiatives required
• Demonstrates leadership in planning new or expanded services, managing projects and coordinating multi-department task forces required
• Demonstrates experience in budget preparation and planning, development and monitoring of staff productivity systems analysis and tracking, quality improvement and establishment of quality standards and monitoring the implementation of other key management control systems required
• Demonstrates commitment to total quality management through knowledge of its precepts, skillful workplace applications and continuous organizational improvement required
Skills and Knowledge:
• Familiarity with general hospital management principles, practices, and procedures
• In-depth knowledge of advanced principles, methods, and techniques related to compliant healthcare billing/collections
• In-depth knowledge of payer contracts, insurance eligibility, the Fair Debt Collection Act and CA charity laws
• Knowledge of patient access functions in acute and non-acute settings including organization, registration, financial clearance, and financial counseling functions and how they interrelate
• In-depth working knowledge of medical terminology and coding
• Knowledge of Patient Access Patient Management information system applications, preferably EPIC
• Knowledge of system interfaces that will include Passport Eligibility, eCashiering, Paperless Registration, Hyland On Base Scanning, Search America and other applications
• Knowledge of reimbursement systems (DRGs, capitation, managed care, etc), the Medicare Peer Review Organization, TJC accreditation standards, state licensing requirements, and state and federal laws, standards, rules, regulations and requirements governing the confidentiality of patient information is essential
• Knowledge of work standards and productivity measures, quality control mechanisms, and workload distribution
• General knowledge of LEAN, Six Sigma, reengineering and/or other process improvement knowledge/experience desired
• General knowledge of HR and payroll policies/ regulations, automated timekeeping systems and budget practices
• Knowledge of technological advancements, labor savings procedures/ processes/ equipment and other state-of-the art department-specific systems
• Knowledge of utilization review principles/practices
• Familiarity with multiple patient access-related information systems and subsystems
• Ability to set strategy and provide superior knowledge of business processes and enabling technologies, specifically in Patient Access functions
• Aptitude to conceptualize, plan, and implement stated goals and objectives
• Ability to identify, prioritize, resolve and / or escalate complex problems promptly
• Ability to identify and implement consistent financial clearance/ counseling approaches across the system
• Thorough understanding and experience with performance metrics
• Ability to establish, develop and manage customer relationships
• Excellent project management, planning and forecasting skills
• Ability to serve as a reference and coach others on key Patient Access process, policies, and procedures
• Demonstrates leadership skills and the ability to provide constructive feedback to team members to support continuous improvement
• Ability to effectively detect, surface and resolve conflicts among individuals and/or work groups
• Ability to communicate ideas both verbally and written to influence others using on-on-one contact, formal presentations, and group discussions
• Effective internal consulting skills along with the ability to positively influence others in a desired direction to achieve identified outcomes without direct lines of authority
• Ability to recognize the appropriate style, level of detail, and message for the audience
• Ability to develop and maintain effective working relationships/ networks within and outside the organization
• Skills using spreadsheet, word processing, statistical, project management, and presentation software applications, preferably Microsoft Suite; ability to learn new applications/software systems effectively and efficiently
• Demonstrates skills developing and administering a complicated budget
• Ability to utilize detailed/ complex information technology to maximize the efficiency and quality of revenue cycle activities; analyze and interpret complex data and draw logical conclusions to develop and address revenue cycle operational processes
• Well-developed process design, implementation, and improvement skills, including large scale transition/ change management
• Requires the ability to work with and maintain confidential information
• Positive influence skills to move others in desired direction without formal lines of authority. This requires tact, diplomacy, polity savvy and executive presence
This list of job elements, responsibilities, skills, duties, requirements, or conditions is not comprehensive, but is merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development).
Primary Location: California, Greater Sacramento Area, Roseville
Organization: Sutter Shared Services
Employee Status: Regular
Employee Referral Bonus: No
Position Status: Exempt
Job Shift: Day
Shift Hours: 8 Hour Shift
Days of the Week Scheduled: Monday-Friday
Weekend Requirements: Other
Schedule: Full Time
Hrs Per 2wk Pay Period: 80
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.