Patient Access Director

Insight Health Systems; Chicago (IL); On-site; USD 120,000 - 180,000; Full time

Job summary

Insight Hospital and Medical Center Chicago is seeking a Director Patient Access to lead pre-registration, insurance verification, authorizations, financial counseling and registration across hospital and clinic services. This role includes handling escalations and coordinating with Corporate Compliance, Clinical Services and other Insight entities.

The Director will drive efficiency, improve patient experience, ensure regulatory compliance, and partner with senior leaders to optimize revenue

Responsibilities

• Oversees patient access functions across the organization, including pre-registration, insurance verification, prior authorization, financial clearance, financial counseling, cashier and registration.
• Addresses escalations from Centralized Scheduling and other areas, including after-hours coverage as needed.
• Works with leaders across departments to ensure regulatory compliance and improve care coordination.
• Develops and implements initiatives to increase efficiency and point-of-service collections.
• Prepares reports for operational leadership on finance, clinical activity, quality, safety, marketing and HR metrics.
• Drives continuous improvement of Patient Access processes and staffing models.

Job description

WE ARE INSIGHT:

At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world‑class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE!

General Summary

The Director Patient Access is responsible for administering coordinating and reviewing the performance of patient access functions across the organization including pre‑registration, insurance verification, prior authorization, financial clearance, financial counseling, cashier and registration for hospital and clinic services. The incumbent is also responsible for addressing registration for hospital and clinic services. The incumbent is also responsible for addressing escalations from Centralized Scheduling, Administration, etc., which may include on‑call availability outside core business hours (24X7). This leader seeks to identify and implement new and emerging strategies to increase efficiency, improve processes, increase point of service collections and enhance the patient’s experience. As part of achieving these goals, the Director Patient Access identifies opportunities to work with leaders in other areas‑including corporate compliance, clinical services, case management, and our Michigan staff to ensure regulatory compliance, increase care coordination and improve process efficiency between department and entities. The Director Patient Access reports to the Director, Revenue Cycle and engages in successful collaboration with Insight employees and leaders.

These duties are to be performed in a highly confidential manner, in accordance with the mission, values and behaviors of Mercy Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers and guests.

Duties and Responsibilities

Departmental Leader

• Provides an experience and environment of patient‑and family‑centered care.
• Interprets impact of broad scope organizational change for staff and develops change strategies for successful implementation.
• Incorporates Insights, mission, vision and values in goals and programs within Patient Access.
• Develops and manages operational initiatives with measurable outcomes.
• Formulates objectives, goals and strategies collaboratively with other stakeholders.
• Prepares and delivers reports to operational leadership outlining progress toward meeting annual goals and objectives, to include performance related to finance, clinical activity, quality, safety, marketing, and human resources.

Financial Manager

• Actively seeks opportunities to improve financial outcomes, engaging staff in the process.
• Establishes annual financial goals and actively uses benchmarking to high performing systems in similar areas of expertise to set annual targets.
• Monitors and analyzes financial data and utilizes it for decisions regarding FTE’s, staffing and operational budget.
• Establishes an annual operating and capital budget, demonstrating fiscal responsibility through meeting budget targets.
• Creates business plan(s), justifying variances and analyzing cost benefit of programs.
• Directs and provides guidance to managers to effectively allocate resources based on patient volume, space availability, budget constraints, and program priorities, goals and objectives.
• Contribute to the success of Insight Health and Hospital by providing leadership, direction and coordination of operations, finances and human resources for area of responsibility.
• Manage and direct all activities within area of responsibility.
• Continually assesses all services, identifies problems, utilizes data to analyze and propose innovative approaches for solutions.
• Maintain records related to operations and services that are complete, accurate, available, and in compliance with all legal, regulatory, and policy requirements.
• Engages staff and other stakeholders in continuous improvement of systems and processes; manages resources for staff participation in improvement work activities.
• Ensures effective facilitation of improvement teams and development of leadership skills to ensure overall effectiveness of the meetings.
• Organizes and prioritizes time and resources to manage efficiently.
• Remains current of new trends and best practices and incorporates into Patient Access practices and programs.
• Articulates and enforces standards for quality/safe patient care.
• Develops and implements innovative systems and processes that improve staff and patient quality and safety.
• Demonstrates achievable and measurable results and develop action plans for improvement.
• Initiates, monitors and enforces regulatory requirements.
• Holds self and others accountable to policy, standards and commitments and provides timely follow through on questions and concerns.
• Ensures development of Patient Access initiatives to improve patient satisfaction and family centered care.
• Actively listens to staff ideas and concerns, assesses others communication styles and adapts to them.
• Effectively facilitates meetings at Patient Access and organizational level.
• Creates bi‑directional systems that effectively communicate information and data, utilizing multiple methods.
• Articulates and presents data, information, and ideas in a clear and concise manner.
• Communicates opinions and ideas in a non‑threatening and non‑judgmental manner to staff, peers and others.
• Communicates with physicians, academic department leaders, and senior administrators to maintain coordination with other Insight programs.
• Demonstrates empathy and concern while ensuring Patient Access goals are met.
• Manages the complex interdepartmental and interdisciplinary relationships to assure collaboration and effective/efficient operations within Patient Access.
• Creates an environment that encourages diverse opinions, recognizes differences and incorporates into process and services.
• Creates a culture and systems for recognizing and rewarding staff.

Resource Manager

• Creates and maintains a satisfying workplace that fosters professional growth and job satisfaction for all members of the healthcare team.
• Interviews to select top talent, matching Patient Access needs with appropriate skill sets.
• Develops and implements recruitment and retention strategies that support a culture of leadership.
• Identifies and addresses own professional growth needs.
• Assesses manager and staff development needs, identifies goals and provides resources.
• Identifies lack of competency in performance and establishes a plan which includes goals, interventions, and measures.
• Maintains membership in professional organization(s) to develop knowledge and resources through networking, continuing education, and participation in national, regional, and/or local activities.
• Ensures integration of ethical standards and core values into everyday work activities.

Educator/Research Facilitator

• Leads and/or serves on a variety of appropriate internal and external committees to represent the Patient Access.
• Serves as a representative of Patient Access to Insight Health and Hospital in order to facilitate the shared interests and relationship between the parties.

Required Knowledge, Skills, and Abilities

• Excellent communication and interpersonal skills include the ability to negotiate and resolve conflicts and build teams.
• Demonstrated creativity and flexibility.
• Ability to operate in high‑pressure situations.
• Excellent organizational skills.
• Ability to work collaboratively across Insight entities and disciplines.
• Demonstrated commitment to patient‑and family centered care.
• Broad knowledge of modern health care administration practices and principles within a managed care environment and/or an academic medical center.
• Effective analytical ability to develop and analyze options, recommend solutions to and solve complex problems and issues.
• Demonstrated effective managerial and administrative leadership of clinical operations.
• Knowledge of principles and techniques used in negotiation as applied to service contracts and equipment purchasing.
• Effective organizational, planning and project management abilities.
• Experience in financial and programmatic presentations.
• Ability to function independently and deal with multiple, simultaneous projects.
• Ability to recognize personal strengths and weaknesses and develop goals for professional growth and achievement.
• Ability to demonstrate a commitment to quality and excellence.
• Effective leadership abilities.
• Ability to implement change in a positive, sensitive, and forward‑thinking manner.
• Planning and problem solving.
• Developing goals and objectives, and establishing priorities.
• Inspires confidence, appropriate risk taking and achievement of high standards.
• Self‑starter with a willingness to try new ideas.
• Positive, can‑do attitude coupled with a sense of urgency.
• Good judgment and ability to act decisively at the right time.
• Ability to persuade others and develop consensus.
• Effective communication skills both in written and verbal presentation with a communication style that is open and fosters trust, credibility and understanding.
• Ability to effect collaborative and promote teamwork.
• Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders.
• Ability to create win/win solutions and relationships.

Insight Employees are required to be vaccinated for COVID‑19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.

Insight is an equal opportunity employer and values workplace diversity!