Job Information
Trinity Health Regional Director, Pre Service (Remote) in Livonia, Michigan
Employment Type:
Full time
Shift:
Day Shift
Description:
POSITION PURPOSE
Remote work based position
Provides strategic leadership and responsibility for promoting the financial viability of the multi-Regional Health Ministry (RHM) Region by effectively managing all aspects of Pre-Service functions for an assigned region. Directs and oversees the department responsible for securing reimbursement for all elective and emergent admitted services. Responsible and accountable for directing and overseeing all Pre-Service functions which includes Scheduling, Nova (Notification, Verification, and Authorization), and ensuring Financial Clearance of planned, emergent and transfer center admissions. Secures reimbursement for all services, including, but not limited to, calculating self-pay rates, insurance out-of-pocket amounts for all payers for all services lines, loan programs, cash collections, proper handling of cash, Medicaid eligibility and financial assistance. Provides oversight responsibility for all decentralized areas and makes certain all processes meet internal and regulatory requirements regardless of reporting structure. Position possesses a full understanding of denial management to prevent denials from occurring at point of service and builds and maintains strong relationships with all providers referring to and providing services onsite at all ministries within the region they serve.
Responsible for developing, modifying, and maintaining policies, which involve continually seeking mechanisms to streamline and automate processes and building and maintaining external and internal customer relationships. Provides financial management, leadership, and expertise in managing all details of assigned operations and works in conjunction with other departments, including but not limited to, clinical services, managed care contracts, Patient Business Service (PBS) center, information services (TIS), general accounting, and other service areas to ensure financial and customer service goals are accomplished. Responsible for systematic approaches that contribute to accurate capture of patient data, point of service collections, exceptional customer service and ongoing optimization of processes and people. Champions and cultivates Diversity, Equality and Inclusion for patients, colleagues, and community.
ESSENTIAL FUNCTIONS
Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
Directs, oversees and manages each functional area of Pre-Service Access to include outpatient scheduling, preadmission testing scheduling, pre-registration, financial clearance and patient payments for all services provided at the ministry.
Directs and oversees department responsible for securing payment for services rendered across the region.
Identifies, facilitates, and builds system and process standardization, utilization of best practices, work integration, change management, issue resolution, metric development and measurement, and communications for an assigned region.
Directs, coordinates, and synchronizes the work efforts of geographically dispersed Pre-Service Access work teams to ensure adherence to the established Standards of Excellence with ongoing monitoring and reporting of performance metrics related to revenue cycle, productivity, quality, timeliness, and patient/colleague satisfaction to senior leadership.
Collaborates with the Regional Vice President Hospital Site Operations in the creation of strategic plans, goals and implementation plans for operations and highly visible and complex programs and projects. Directs and oversees the development and maintenance of departmental operating and capital budgets to control expenditures and to ensure budget goals are met, which includes monitoring and analysis of performance metrics.
Directs and oversees human resource activities, which includes recruitment of staff, completing appropriate documentation, performance appraisals and leading goal setting. Adheres to all human resources expectations for colleagues, including compliance related responsibilities, orientation and continuing education requirements, recognition of staff/team accomplishments, etc. May terminate positions when necessary.
Responsible for establishing relationships and leading collaborative efforts with physicians, physician office personnel, clinical service line leaders; may provide education to the professional partners relative to rules and regulations that govern Pre-Service Access functions and ultimately drive reimbursement outcomes
Oversees and ensures local leadership and teams have appropriate internal controls over accounts receivable records, clinical record integrity, cash collections, patient valuables, etc.
Oversees customer service and will act as point of escalation for patient complaints or related issues. Ensures processes are in place to support prompt and appropriate handling of patient inquiries in a manner that is professional, understanding, patient and respectful.
Responsible for serving as primary liaison for any new Pre-Service/Patient Access related systems, enhancements or other related initiatives that affect the region's patient access operations, which includes ensuring at least annual review of departmental policies and processes in accordance with JCAHO and other regulatory considerations.
Oversees and monitors process flow across other departments, and involves them, as appropriate, when recommended actions may affect their work functions. Serves as resource to all revenue cycle staff on the development, implementation and maintenance of efficient operations, functions, and services.
Directs, oversees, mentors, and provides guidance to Pre-Service Access team in order to foster a team atmosphere within department and across region. Supports recruitment activities and oversees the development and education of staff.
Maintains professional development, and growth and participates in appropriate continuing education programs and committees.
Other duties as assigned.
Must possess the ability to comply with Trinity Health policies and procedures. Must be comfortable operating in a collaborative, shared leadership environment.
Maintains a working knowledge of applicable federal, state, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence and compliance in a manner that reflects honest, ethical, and professional behavior
Hourly pay range: $64.9341 - 107.1413
MINIMUM QUALIFICATIONS
Must possess a comprehensive knowledge of hospital Patient Access/ Accounting management as normally acquired through the completion of bachelor’s degree in finance, or related field; or equivalent combination of education and experience in patient registration, financial assistance programs, 3rd party eligibility requirements, point-of-service collections, appointment scheduling. Master's degree preferred.
Minimum of seven (7) to ten (10) years of Patient Access leadership experience in a multi-facility, integrated healthcare delivery system with direct responsibility for all aspects of financial clearance.
Patient Accounting leadership experience strongly preferred with an exceptional knowledge of denial management.
Must possess strong knowledge of all aspects of financial clearance including but not limited to; payer / government / state regulatory requirements, payer contracts/reimbursements and clinical requirements for services. Strong understanding of cash collections and the proper handling and reconciliation of cash.
National certification in NAHAM CHAM and / or HFMA CHFP or CRCR required within one (1) year of hire.
Strong understanding of denial management and what is needed to receive reimbursement based on initial claim submission.
Strong background in working with multi-disciplinary team, varying levels of leadership across the organization, including C-Suite and the demonstrated ability to be a change advocate, promote process improvement and ongoing education and growing the knowledge of team
Exhibits strong leadership and management skills with the ability to attract, develop, deploy, and retain an excellent revenue cycle team, capable of performing as a team and of evolving with the organization’s vision and with cutting-edge technologies.
Must possess strong analytical skills to detect and resolve problems related to accounts receivable and system implementations. Ability to address complex problems with multi-level impacts and with solutions not readily apparent and uses sound judgment, in-depth analysis, and expertise to resolve issues.
Ability to prioritize and deliver key initiatives; demonstrated success in achievement of key performance metrics targets within time and budget constraints.
Must possess strong written and verbal communication and organizational skills and demonstrated ability to effectively manage department and communicate with a wide-ranging audience.
Demonstrated understanding and practical experience in project management, revenue cycle, technology infrastructure, integration, and related issues.
Must be comfortable operating in a collaborative, shared leadership environment.
Must be proficient in all Microsoft products and Internet Explorer.
Must be comfortable operating 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
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.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
This position operates in a typical office environment. The area is well lit, temperature controlled and free from hazards.
Incumbent communicates frequently, in person and over the phone, with people in all locations on product support issues.
Manual dexterity is needed to operate a keyboard. Hearing is needed for extensive telephone and in person communication.
The environment in which the incumbent will work requires the ability to concentrate, meet deadlines, work on several projects at the same time and adapt to interruptions.
Must be able to set and organize own work priorities and adapt to them as they change frequently. 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.
Ability to thrive in a fast-paced, multi-customer environment, with conflicting needs which some may find stressful. May warrant varied and/or extended hours, with changes in workload and priorities to keep pace with the industry and advance strategic priorities.
Must possess the ability to comply with Trinity Health policies and procedures.
Must be able to travel up to 20% to the various Trinity Health sites or physician offices within the Region. May travel to RHMs outside of the Region and System Office as necessary, typically under 10% of the time.
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.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
EOE including disability/veteran