Director, Opsc Business Ops - Pediatric Outpatient

Memorialcare Health System Long Beach , CA 90802

Posted 6 months ago

This position is responsible for the direct supervision of the Care Associates and office staff for MCH OPSC Departments as it relates to the business operations for the centers. The Director of OPSC Business Operations will also partner with the Clinical Ops Director with nursing staff and physicians regarding the processes and documentation for exceptional customer/patient services as well as thorough clinical documentation supporting regulatory and fiscal requirements. The Business Ops Director is responsible for creating and implementing a coordinated scheduling system through Epic as well as implement technologies and call center to decrease no shows and late cancellations with patients. By developing, training and implementing enhanced and new technologies and processes, there will be a direct correlation with improved revenue and decreased write-offs for OPSC. This role will work directly with the compliance team and patient financial services to assess current billing vendor and recommend best practices for future work with an attached ROI. The Director of OPSC Business Operations will create standard work and audit tools to support optimal the business aspects of the clinic operations. The Director will create and review operational reports regarding billing, optimal scheduling, late cancellations and insurance denials. These reports will serve as key tools for the Director to identify patterns and implement change to support best practice in the business operations for OPSC. The Director of Business Operations will be the leader in the development and implementation of efficient and complete processes to meet the target for an improved budget for OPSC.

Principal Duties and Responsibilities:

  • Leads in the design and direction of creating the Miller Children's Village for consolidated specialty centers in Long Beach, meeting and exceeding revenue targets.

  • Design and implement training and tools to support daily review of standard work and work queues for registration, eligibility, scheduling and authorizations to reinforce standard work, timeline requirements and quality processes.

  • Oversee staff regarding their work and outcomes supporting integrated scheduling and optimal billing results.

  • Develop and implement audit tools in conjunction with the campus CFO and Corporate Audit to identify individual staff and department patterns as it relates to optimal business operations for OPSC. Coaches and/or counsels staff to meet or exceed performance expectations to support the OPSC business.

  • Works directly with physicians representing at least 27 specialties as well as third party billing to meet regulatory and fiscal requirements for clinical documentation and billing.

  • Serves as an OPSC/Miller's leader with Argus (3rd party biller) and actively participates in the analysis and recommendations for OPSC at it relates to external vs. internal billing services. Identify gaps in collections and implement processes and tools to eliminate billing errors.

  • Serves as an expert leader in OPSC business models to assist in the audit process regarding compliance and revenue

  • Develop and implement standard work regarding clinical research conducted in OPSC to meet costs associated with a patient in a research study and IRB requirements.

  • Works with and implements a process for physicians, department and Foundation regarding documentation and billing for philanthropic grants.

  • Leads the project plan for MCH on the MHS project to design and implement a phased approach for a 3rd party call center for OPSC to improve customer satisfaction and decrease open appointments slots related to late cancellations and no shows for OPSC. Builds and monitors the ROI for this project as well as serve as Miller Children's Hospital representative in the larger MemorialCare system wide call center initiative.

  • Ten years' experience and progressive leadership roles in hospital or outpatient medical group practice in a pediatric setting.

  • Working knowledge of regulatory and billing requirements.

  • Must be comfortable utilizing electronic medical records.

  • Demonstrates critical thinking and analytical skills and the development and implementation of project plans.

  • Complex budget management experience required.

  • Lean Management or Six Sigma experience preferred.

  • Experience with direct supervision of staff Excellent written and verbal communications required.

  • Proven ability to work and communicate with physicians and key executive leaders.

Education:

BSN & RN required due to the clinical nature of the business complexities.


upload resume icon
See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Director Of Nursing (Don) For Home Health Agency
New!

California Job Shop

Posted Today

VIEW JOBS 1/17/2019 12:00:00 AM 2019-04-17T00:00 <div>Job Opening:  Director of Nursing (DON) for Home Health Agency<br /> <br /> Location:  Long Beach, CA 90802<br /> <br /> The Director of Nursing is responsible for the overall direction of home health care clinical services and has the overall responsibility for the quality of services provided and supervision of clinical staff. The Director of Nursing assures coordination of care for clients and provides overall clinical supervision of all clients.</div> <div>Duties:</div> 1.  Works closely with the Administrator to ensure quality services and policies are followed.<br /> 2.  Is available at all times during regular business hours and as needed to provide support and assure quality care delivery to home care clients.<br /> 3.  Meets with Case Managers/clinical staff on a regular basis to provide guidance and information related to specific issues.<br /> 4.  Provides direction to teams to assure that client needs are met and services are provided according to the plan.<br /> 5.  Assists clinical staff in establishing priorities, setting goals, and evaluating progress toward goals.<br /> 6.  Supervises, educates and coaches other nursing personnel, as appropriate.<br /> 7.  Attends case conferences and other clinical meetings to facilitate coordination of care.<br /> 8.  Reviews monthly team members’ productivity information.<br /> 9.  Follows agency protocols to assure proper maintenance of client clinical records, statistics, reports and records for purposes of evaluation and reporting of organization activities.<br /> 10.  Develops working relationships with other health care professionals in the community and families to identify resources available and to ensure access of information to clients.<br /> 11.  Provides support and direction to Agency staff, other health care professionals, clients, and families related to appropriate and available health care resources.<br /> 12.  Educates Agency staff on clinical services, policies, and procedures as needed.<br /> 13.  Facilitates problem-solving sessions to enable Case Managers and other staff to resolve client and/or reimbursement source issues.<br /> 14.  Identifies and participates in performance improvement activities, maintaining compliance with State of CA Home Health regulations and Conditions of Participation.<br /> 15.  Write and acquire Prior Authorization for Medicare and other insurance authorizations. <div><br /> Requirements<br /> <br /> 1.  RN degree required, BSN desired<br /> 2.  Minimum of 5 years RN experience in a Home Health setting, 10 years experience desired<br /> 3.  2+ years DON experience required, 5+ years DON experience desired<br /> 4.  Driver's license<br /> 5.  Experience with Medicare<br /> <br /> Compensation:  $110,000-$150,000 plus full benefits including gym, 401K, medical, dental, vision, Flexspending, training, CEUs, weekly pay, EMC charting.</div> California Job Shop Long Beach CA

Director, Opsc Business Ops - Pediatric Outpatient

Memorialcare Health System