Director Patient Access - Clinic

Location:

Avera Health

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Position Highlights

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

A Brief Overview

The Director - Patient Access Ambulatory is responsible for administering, coordinating, and monitoring the performance of ambulatory patient access operations across the organization, including scheduling, pre-registration, insurance verification, referral management, prior authorization, financial clearance, and registration in partnership with clinic departments and Avera service lines. This leader serves as member of the Patient Access Leadership team and ensures that assigned programs, functions and operations conform to organizational goals and objectives, seeking to implement emerging best practice strategies to increase front-end efficiencies and enhance the overall patient experience. To achieve these goals, the Director of Ambulatory Patient Access identifies opportunities to work with leaders in other operational areas as needed to ensure regulatory compliance, increase care coordination, and improve communication among departments.

What you will do

• In close coordination with service line leaders and clinic managers, directs the planning, design, and coordination of front-end processes and programs in areas within the Patient Access Department including but not limited to financial clearance and wellness (Pre-Registration, Scheduling, Prior Authorization and Insurance verification) and front desk workflows (patient communications, phone calls, and other business office functions).
• Directs the departmental quality improvement efforts in coordination with the Patient Access Quality team to achieve optimal productivity, operational effectiveness, efficiency and satisfaction of internal and external customers. External customers include patients, referring providers, physicians and third-party payers.
• Works with physicians, both internal and external, and advises the financial clearance and registration of patients from an administrative and financial perspective. Reviews and approves exceptions for patients requiring financial clearance.
• Maintains a thorough knowledge of third-party reimbursement procedures and requirements. Interprets rules and regulations for clinic staff. Reviews contracts the system has with payers, and provides preferred language to be used for precertification, referrals, and insurance verification.
• Develops and manages operational initiatives with measurable outcomes. Formulates objectives, goals and strategies collaboratively with other stakeholders. Ensures awareness and compliance with all applicable laws, regulations, guidelines, and professional standards at the federal, state, and agency levels.
• Establishes annual financial goals and actively uses benchmarking to high performing systems in similar area of expertise to set annual targets.
• Monitors and analyzes financial data and utilizes for decisions regarding FTE’s, staffing and operational budget. Directs and provides guidance to managers to effectively allocate resources based on patient volume, space availability, budget constraints, and program priorities, goals and objectives.
• Accountable for maintaining the organization’s fiscal strength through financial clearance of patients and denial management.
• Actively participate in system-wide committees and workgroups to facilitate interdepartmental activities addressing issues with a broad scope of impacts for the system.
• Partners with Clinical Operations to assure operational integration of revenue cycle workflows and functions, as well as future planning for collaboration.
• Responsibilities include interviewing, hiring, developing, training, and retaining employees; planning, assigning, and leading work; appraising performance; rewarding and coaching employees; addressing complaints and resolving problems.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Required Education, License/Certification, or Work Experience:

• Bachelor's Healthcare, Business Administration or related field.
• 4-6 years Progressive leadership experience related to healthcare revenue cycle.
• 7-9 years Experience working in a revenue cycle environment, with some patient access experience required.
• Advanced knowledge of scheduling, pre-registration, insurance verification, prior authorization, financial clearance, and registration processes in the clinic environment.

Preferred Education, License/Certification, or Work Experience:

• Master's Healthcare, Business Administration or related field.

Expectations and Standards

• Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
• Promote Avera’s values of compassion, hospitality, and stewardship.
• Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.

• PTO front-loaded for eligible hires

• Free health insurance options, for full-time single coverage on Avera High Deductible Health Plan

• Up to 5% employer matching contribution for retirement

• Career development guided by hands-on training and mentorship

Avera is an Equal Opportunity/Affirmative Action Employer Minority/Female/Disabled/Veteran/Sexual Orientation/Gender Identity. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.