Munson Healthcare Practice Administrator - Cowell Family Cancer Center in Traverse City, Michigan
Responsible for the overall non clinical operations of the assigned physician network practices including operational efficiency, personnel, finance, revenue cycle, information technology and all other administrative aspects of the network practices. Implements strategic and operating plans as well as system policies and procedures. Provides data analysis to assess practice performance and drives performance improvement activities. Represents the practices with internal and external parties in the business transactions of the practice.
Bachelor’s degree in business, health care administration, or related field. Master’s degree in health administration or business administration preferred.
A minimum 5 years’experience including office practice management, financial analysis, revenue cycle operations, forecasting, and budgeting is required. Excellent analytical, verbal and written communication skills required. Experience in payor quality and population health programs strongly preferred.
Experience in oncology practice strongly preferred.
Demonstrated understanding of health care finance, statistics and data management is required.
Demonstrated ability to establish collegial relationships with physicians is required. Demonstrated entrepreneurship and creativity in problem solving. Personal computer literacy and knowledge of Electronic Health Records is required.
REPORTS TO : Vice President, Operations
Dotted Line Report to applicable Service Line Executive Director &
System Director of Practice Operations
POPULATIONS SERVED, COMPETENCIES, INCLUDING AGE OF PATIENTS SERVED
Cares for patients in the age category(s) checked below:
X No direct clinical contact with patients
LANGUAGE SKILLS Must be able to read, speak and write fluently in English. Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups or managers, clients, customers and the general public.
MATHEMATICAL SKILLS Ability to add, subtract, multiply and divide in all units of measure using whole number, common fractions and decimals. Ability to compute rate, ration and percent and interpret graphs.
PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
May view computer screen for extended periods of time.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
WORK ENVIRONMENT The work environment characteristics described here are representative of those an individual encounters while performing the essential functions of this job. All individuals must be made aware of CLIA/OSHA/NRC requirements as they pertain to their job. Works in a well-lit, clean and smoke-free environment. Work may be subject to frequent interruptions.
REASONING ABILITY Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Must be able to process multi task functions with the ability to prioritize and review processes.
Supports the Mission, Vision and Values of Munson Healthcare
Embraces and supports the Performance Improvement philosophy of Munson Healthcare.
Promotes personal and patient safety.
Uses effective customer service/interpersonal skills at all times.
Other duties as assigned
Assures practices operate efficiently and meet or exceed budgetary expectations.
Monitor financial and operational metrics to identify variances and develop action plans to drive continual operational improvement.
Monitor practice revenue cycle KPI performance in partnership with CBO; implement action plans as necessary to improve performance.
Implement and monitor processes to ensure optimal charge capture and charge reconciliation for professional and facility billable services as applicable.
Implement and monitor processes to optimize registration, scheduling, referral coordination and pre-authorizations. Ensure practice compliance with system policies & procedures and standard operating procedures around front end revenue cycle processes.
Implement and monitor processes to optimize point of service cash collections within assigned practices.
Assure that Information Systems are meeting the needs of the practices, ensures business analytics/EHR support is focused and accountable. Provides leadership in system implementations in partnership with IT and ambulatory informatics.
Review, revise and enforce MHC system standard operating policies and procedures for non-physician personnel.
Achieve P4P metrics (PQRS, PGIP, BCBS Specialists uplift, others), work with physicians and practice staff to drive continuous improvement in payor quality initiatives.
Insure compliance with all Federal, State and other regulatory body requirements related to the Practice.
Seek out, recommend, and implement methods for improving internal efficiency in such areas as patient flow, manpower/equipment utilization, cash flow and space needs.
Monitor levels of patient service and patient satisfaction. Represent practices in system forums related to the patient experience. Develop and implement action plans to continually improve patient satisfaction scores.
Schedules and manages outreach operations across the system.
Support physician compensation and contract development activities, as requested by administration.
Provide leadership and direction for the employees of the Practice and managers to maintain a constructive working environment for employees and physicians.Develop and maintain an effective, efficient organizational structure consistent with the standards identified for the MHC physician network.
Manage employee relations, including compliance with personnel policies.
Insure that staff are appropriately trained and informed, with opportunities for professional development, as appropriate.
Participate and implement communication strategies to keep employees, physicians and others well informed of changes, updates.
Ensure annual performance reviews are conducted on all practice staff.
Direct recruitment, hiring and any termination of staff.
Insure staff complies with customer expectations and care coordination initiatives.
Monitor the financial performance of the assigned practices and individual physicians. Develop variance reports and action plans to achieve operational budget targets as necessary.
Participates in the development of annual practice operational and capital budgets.
Oversee in collaboration with CBO, efficient management of patient accounts, including accounts receivable, processing of medical insurance claims, reimbursement levels and documentation requirements.
Recommend fee schedule changes, as needed; maintain fee policies.
Insure that payroll, checking and other financial systems are efficiently operating.
Reviews, designs and implements processes surrounding pre-registration, centralized scheduling, reception, registration, financial navigators, POS Collections are optimized, provider referrals, credentialing of providers, coding, pricing, billing, third party payer relationships, and collection management of accounts receivable to ensure that the revenue cycle is optimized.
Leads the coordination of activities between clinical and financial functions in the outpatient center/clinic.
Oversees and maintains systems to ensure that hospital technical and physician professional charges are correctly captured and billed in a timely manner.
Analyzes reimbursement from all sources, including carrier reimbursement exception reporting and follow up pending claims analysis and denials management.
Provides leadership, drives change, and facilitates process improvements.
Insure integrity of medical records system and compliance with respective documentation policies and procedures.
Oversee administrative aspects of clinical services and engage physician network clinical leadership to resolve clinical issues as necessary.
Address risk management issues, as appropriate.
Provide outreach oversight for physician schedules and collaboration with affiliates.
Participates with the respective Service Line Executive Director in the development of strategic and operating plans to guide the growth and development of the assigned network practices. Implements strategic tactics for practice growth, efficiency, and quality in the short-term (1-2 years) and the long term (5 years).
Research, identify and recommend new opportunities to enhance the practice; evaluate opportunities proposed by others for their impact on the practices.
Anticipate issues that may have a major impact on the practices; analyze problems and present solutions.
Assess reimbursement changes affecting the practices, recommend solutions. Prepare practices for pay-for-performance expectations.
Participate in service line programmatic planning for work flow improvements and improvements with care coordination.
Represent the Practice in dealing with external groups, including other health care providers, hospitals, insurers, employers and community groups.
Participate as requested in activities associated with Northern Physician Organization (physicians’ member PO), HMO’s, PPO’s and other payers.
Provide administrative representation for the Practices with other joint venture or collaborative activities.
Participate in community, philanthropic, and professional organization as a represented leader.