Associate Vice President, Patient Financial Services


Back
Job Number 54016
Posted 4/11/2018
Account EMHS
Department Revenue Cycle
Location EMHS - Cumberland Place, Bangor, ME 04401
Schedule Regular Full-time
Shift Day
Hours 8-430
Job Details SUMMARY
Reporting to the VP of Revenue Cycle of Eastern Maine Healthcare Systems, this position is responsible for providing leadership for all activities related to the management of EMHS's Patient Financial Services (PFS) function. The Associate Vice President of Patient Financial Services sets the strategic direction for all of EMHS's hospitals, affiliates, physician services and ancillary services for the Patient Financial Services function within the Enterprise Revenue Cycle. The AVP of Patient Financial Services is responsible for providing direction and leadership to achieve ongoing operational quality, productivity and efficiency in the Patient Financial Services department, both with the hospitals and physician practices. The AVP is responsible for planning, directing and overseeing the performance of the functional areas that report to this position including Claims Processing, Accounts Receivable Management, Payment Posting and Reconciliation, Denials and Underpayment Management, Credit Management, Self-Pay and AR Collections. The role serves as the leader of the Patient Financial Services Department for Eastern Maine Healthcare Systems to internal and external organizations, including government agencies, payer organizations and external auditors.

PRIMARY RESPONSIBILITIES / DUTIES

· Setting the strategic direction for the EMHS Patient Financial Services, Revenue Cycle function

· Participate on revenue cycle leadership team overseeing key operational and financial decisions pertaining to the revenue cycle

· Develop, implement, and manage efficient and effective operational policies, processes and best practices within patient financial service (PFS) functions of the revenue cycle which include claims processing, payment posting/credit balance management, third-party follow-up and patient A/R management, adjustment and denial and underpayment processing, managed care compliance, contract management, and other support services

· Implement enterprise-wide projects, as assigned, for realizing process improvement opportunities within patient financial services

· Participate in various IT-related steering committees for information technology changes which affect the patient financial services area and lead project groups as assigned

· Develop and enforce all PFS corporate policies including; account adjustments and write-offs, and collection efforts in collaboration with the VP of Revenue Cycle

· Develop multi-disciplinary Patient Financial Services teams to enhance quality and efficiency

· Produce various financial reports/dashboards, including but not limited to month-end financial reporting, receivables levels (days in AR and aging), and any long-range strategic plans for the department

· Set annual goals for patient financial services key performance indicators and report departmental performance around goals and national benchmarks to the Health System's revenue cycle stakeholders

· Routinely conduct payer trend analysis to ensure optimal reimbursement, identify issues, and communicate findings to the Health System's revenue cycle stakeholders

· Ensure compliance with federal and state laws specifically pertaining to patient financial services by analyzing internal policies and implementing appropriate changes

· Oversee and review PFS external audits to prevent internal control weaknesses and to ensure an independent and objective evaluation of the operation

· Assist in evaluating purchases, contracts and services provided by external vendors to ensure best pricing and effective results (collection agencies, claims/statement vendors, reference tools, software tools, etc.)

Budget Responsibility

· Administers expense budget for department

· Presents departmental budget recommendations to VP of Revenue Cycle for approval

· Monitors budget performance and variance explanations

· Optimizes vendor relationships as necessary

· Evaluates current and new technology solutions

Authority / Decision Making Level

· Prioritizes and organizes work within division to meet changing priorities

· Approves account adjustments, refund requests, and bad debt placements for accounts over specified threshold; forwards all adjustments requests greater specified threshold to VP of Revenue Cycle for approval

· Reviews and approves policies and procedures for the PFS revenue cycle department for the hospitals as well as the related policies and procedures for the physician practices.

Supervisory Responsibility

· Directs activities of staff Directors and Managers that oversee all aspects of Patient Financial Services

· Provides leadership to direct reports and develops them into strategic thinkers and leaders across the organization

· Manages direct reports and has responsibility for hiring, firing, performance management and results of the assigned area

· Authorizes PEP requests for direct reports

· Approves initiation of disciplinary proceedings for staff, in consultation with Human Resources

Leadership

· Provides strategic vision and direction to effectively manage industry shifts, regulatory changes, and rising cost pressures relating to PFS revenue cycle functions

· Evaluates, monitors and assists in developing the priorities and progress of the Revenue Cycle Department

· Provides senior leadership with information regarding receivable and/or departmental performance

· Through management and staff, implements improvements in work process that both improve the efficiency and effectiveness of the PFS department within revenue cycle

· Leads redesign initiatives and other EMHS-sponsored initiatives as requested

· Designs easily understood and impactful managerial reports for wide distribution

· Working with management staff, monitors payer and vendor activities and communications

· Stresses attention to detail and designs monitoring tools to ensure accuracy

· Identifies opportunities for improved efficiency through better processes and additional automation. Monitors impact of process-oriented changes on staffing requirements

· Coordinates and collaborates with key functions outside of Patient Financial Services to ensure strategic alignment with broader organizational goals and objectives

· Serves as an organizational sponsor for implementation of any software applications or technology enablers that improve the overall functionality of Patient Financial Services.

· Functions effectively in a Matrix Management environment

People

· Leads strategically through empowering staff and developing direct reports

· Demonstrates leadership and commitment to staff and colleagues by accepting accountability for outcomes, sharing timely information, building effective relationships and communicating clearly and directly

· Ensures adequate training is being provided to staff to educate on the following skills: current working knowledge of payer requirements; sufficient healthcare knowledge necessary to perform job requirements; knowledge of state, local and federal policy requirements for functions performed; and relevant knowledge of information technologies

· Leads and coordinates ongoing staff evaluation, retention, training and management of policies and procedures

· Manages and oversees staff performance through performance planning, coaching and performance appraisals

· Oversees and ensures two-way communication with PFS staff and Revenue Cycle and hospital/physician leadership

Process

· Develops, implements, and manages efficient and effective operational policies, processes and performance monitoring across all functions of the Revenue Cycle Department

· Ensures Patient Financial Services staff comply with established policies, processes, and quality assurance programs

· Provides ongoing feedback loop communication to other Revenue Cycle areas regarding issues/trends

· Routinely coordinates payor trend analysis to ensure optimal processing and reimbursement, identify issues, communicate findings to Revenue Cycle stakeholders, define solutions and initiate resolution



Performance Monitoring

· Measures and reports ongoing financial and operational performance of the PFS Revenue Cycle department. Recognizes areas of excellence and oversee the development and implement action plans related to functional areas where performance is not meeting expectations

· Manages/communicates the department dashboard and design action plans as issues are identified within the unit

· Ensures that key performance metrics are met on a monthly basis

QUALIFICATIONS

Experience & Education

•Bachelor's Degree is required, preferably in the field of business, finance, healthcare administration, management or related field. A Bachelor's Degree in an unrelated field along with experience that commensurate the knowledge and skills needed to perform the role will be considered.

•Master level degree is preferred. 5 years of experience in a related field with a minimum of three of those years in a management capacity.

•Prior work experience should include a role in a redesign project.

•Experienced in using team building to positively influence the work environment.



Knowledge

· Significant understanding of healthcare business and revenue cycle principles, with special emphasis on hospital and physician patient financial services

· Demonstrated knowledge of healthcare management, registration, billing and collection processes for government, grant, and non-government funding sources

· Strong organizational skills, working effectively in a multi-task environment

· Demonstrated proficiency in written and verbal communication skills

· Demonstrated ability in leadership

· Ability to relate cooperatively and constructively with clients, co-workers, administration, other clinic departments, providers, community agencies, and other health team members

· Ability to work in a fast paced environment and remain flexible under stressful situations


Equal Opportunity Employment
We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.
Back