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