Process Improvement Program Manager

Description

The Process Improvement Program Manager will drive improvements of processes and programs in Central Scheduling, Patient Access Services (Admitting), and Patient Accounts Management (Billing).

RESPONSIBILITIES (ESSENTIAL FUNCTIONS):

• Reviews current processes in Central Scheduling, Patient Access Services, and Patient Accounts Management to thoroughly understand current processes. Reviews current status of patient accounts to identify and resolve billing and processing problems in a timely manner; Establishes and implements a system for the collection of delinquent accounts ensuring third party payers are contacted; Establishes and recommends credit and collection policies.
• Identify current process and program needs. Communicates with managers, supervisors and employees to identify training and development needs.
• Partner with leaders to establish performance objectives for team members in order to customize training and processes to assist in attaining goals.
• Measure department or function data and review results regularly. Monitor daily operating activity of department and make necessary adjustments in workflows and/or standard operating procedures. Review Department Metrics each month to measure the effectiveness of key RCM processes (patient registration, claims submission, denial management and payment posting) against industry benchmarks. Interpret data into needs and objectives for improvement.
• Create, review, and adjust team member key performance indicators (i.e. utilization rate, average task completion rate, appeal rate). Implement and measure changes under direction of and in collaboration with Director.
• Create, maintain, and execute team training and development. Identify and partner with subject matter experts to develop content and design written training materials.
• Build, maintain, and improve program documentation. Establish and maintain standard processes and procedure for each area.
• Create training schedule and facilitate virtual training for new and existing team members. Provide onsite or virtual go-live support to revenue cycle team members during
• implementations, affiliations, and other significant operational changes.
• Leverage technology and tools to develop dashboards, reports, or presentations.
• Propose lifecycle initiatives, considering factors such as cost-effectiveness, technical feasibility, and facility integration.
• Maintain knowledge of and complies with established policies and procedures including governmental, insurance, and third-party payer regulations.
• Maintains professional and technical knowledge through continuing education opportunities including internal and external educational offerings.
• Must adhere to safety protocols at all times.
• Per DRH policy, all required conditions of employment must be met and maintained including required vaccinations.
• Implement DRH Standards of Behavior and exhibit behaviors consistent with DRH core values.
• Performs other related duties as assigned.

Qualifications

Minimum Qualifications: At least 5 years of experience demonstrating strong process improvement or program management skills creating projects, processes, or programs from concept to execution. Healthcare business office including experience in the Home Health/Hospice area and/or Physician billing/collections preferred.

Demonstrated knowledge of: business management; relevant computer programs, spreadsheets, and applications; medical terminology and coding; third-party/insurance company operating procedures, regulations, and billing requirements and government reimbursement programs; provider and facility credentialing; working with CAQH profiles as well as revalidation process; negotiated agreements and managed care contracting. Skill in leadership, customer service, establishing and maintaining effective working relationships with others, development of others, and cost containment.

Exceptional interpersonal skills for written, verbal, presentation, and computer communication required. Demonstrated ability to remain calm and flexible to lead others and establish goals in a fast paced or high-pressure environment. Ability to adapt procedures, processes, tools, equipment, and techniques to accomplish the requirements of the position. Communication skills including fluency in oral and written English. Basic computer skills including the ability to send/receive email, navigate information technology associated with the position, and use Electronic Health Record information tools.

Education and/or Experience: Bachelor’s degree in related area. Significant, directly-related work experience may be considered in lieu of degree.

Certifications, Licenses, Registrations: For those positions requiring travel, a current valid driver’s license and automobile liability insurance must be maintained.

Non Safety-Sensitive Position

As a condition of employment, vaccinations are required per DRH Policy. Medical and Religious Exemptions are available upon request.