Position Summary

The Manager manages, leads and coordinates the development and implementation of outpatient programs and services, patient care service delivery, and the direct management of staff in Adult Multispecialty Center consistent with the mission, vision and strategic plan of LBMC.

Principal Duties and Responsibilities

Using Lean systems and methods, the Manager will develop, plan, organize, direct, and evaluate people, services and processes, assure adherence and provide leadership for quality and continuous improvement for redesign of the healthcare delivery structure to position the organization to maximize the revenue cycle.  The Manager supervises, coordinates, and manages the day to day operations of the department and budgeted staff. The Manager has expertise in systems/standards development, IS systems used within the departments, regulatory requirements and a broad vision of the future of the health care industry. 

The Manager has overall responsibility to plan, organize, coordinate, manage and evaluate people, activities, and processes and operations to assure adherence, quality, cost effectiveness, and continuous improvement with patient/family centered care for:

Business Operations Coordination

• Create standard work for revenue cycle functions
• Advise, analyze, develop and recommend process functionality directly related to the Registration and Eligibility Process
• Evaluate, recommend and support the authorization process for services provided to ensure payment
• Review, research, and resolve charge errors and work queue errors to maximize charge capture and timely billing
• Provide support and teach/train problem solving tools to clinical operations teams to prevent and resolve surprise billing or other billing issues
• Educate staff on current work and changes with the revenue cycle work of the outpatient departments educating clinical leaders and staff of changes when needed.

Outpatient Services

• Outpatient Access: staff and operations that are budgeted across multiple six-digit departments in multiple/dispirit locations with multiple and varied programs, contracts and reimbursement parameters:
• Authorizations for treatment prior to service and subsequent per guidelines
• Assures contracts are in place for the program needed and/or coordinates letters of agreement
• Scheduling maximizes the availability and minimizes patient wait times
• Processes to timely address both clinical and non-clinical billing work ques to assure timely reimbursement and enhance revenue
• Administration of the prompt pay discount and the cash discount policy for Outpatient Services.
• Processes to appeal claims, coding and clinical denials
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• Outpatient Services registration, eligibility and scheduling: centralized under the Manager’s control:
• Operations of registration, eligibility and scheduling are continuously monitored and improved to meet best practice standards
• Co-pay collections per MHS policy and standards.
• Epic work flow, processes and work ques are completed per standard and allow for accurate billing and scheduling.
• Patient and family centered processes and communication with patient/family about services, acceptance processes, insurance etc.

Business Initiatives

The Manger aims to increase revenue by increasing account referrals:

• Identifies new areas of business expansion and innovation to increase patient base.
• Collaborates with Outpatient Services, Managed Care and others to identify areas of potential business growth and improvement.
• At all times, considers how Outpatient Services communications strategies may promote the quality vision of the hospital and enhance its reputation within the community

Plan, develop and implement policies/procedures, program design, educational programs, marketing and philanthropic planning, for Adult Multispecialty Center Services including:

• Patient care service delivery
• Direct Management of staff using standard work, standard work audits and human resource requirements
• Continuous improvement using LEAN methodologies
• Achieve financial targets for expenditures and revenue capture
• Grant capture and management
• Physician and Ancillary Departments contract management
• Oversight and coordination of the City of Long Beach (COLB) Executive Physical Program
• Oversight and coordination of Pelvic Floor Program for LBMC
• Managing and overseeing quality improvement programs; currently for Cystic Fibrosis with the plan to expand QI programs in the future
• Transitioning adult patients from the Pediatric OPSC to AMSC
• Overseeing billing for Neuro IR, COLB, and Adult IR programs
• Coordinating AMSC EPIC build