Manager - Scheduling And Pre - service (98% Remote & 2% Onsite - muskegon, Michigan)

Job Manager, Central Scheduling And Pre-Service/Financial Clearance

Position Purpose: 98% Work Remote & 2% Onsite - Muskegon, Michigan

This position is responsible for leading and directing the work of the Central Scheduling and the Pre-Service/Financial Clearance Units within the Ministry Organization’s Patient Access department. The Manager is expected to motivate staff to achieve the highest levels of customer satisfaction and to meet the organization goals for customer service and financial performance. The incumbent optimizes staff performance through process redesign, policy/procedure implementation, communications, continuing education and professional development activities, staff empowerment and outcome feedback.

Essential Functions:

• Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
• Manages staff, processes & systems and handles activities that relate to:
• Patient scheduling, medical order processing, medical necessity review (LMRP/LCD review), dissemination of patient information, and support coverage of other departmental divisions and pre-registration if this function has been established as part of the scheduling associate job description.
• Pre-Service/Financial Clearance activities, including Pre-Registration, Medical Necessity Screening (LMRP/LCD Review), Insurance Eligibility/Benefit Verification, Service Authorization (Pre-Certification/Referral), Pre-Service Collections; Pre-Service Financial Counseling and Pre-Service Eligibility Assistance; dissemination of patient information; and support coverage of other departmental divisions.
• Provides guidance and direction to assigned staff to ensure effective integration and coordination of departmental work activities and quality job performance.
• Serves as technical advisor and resource to staff.
• Provides educational support to non-centralized pre-registration areas.
• Manages local PHS schedule database administrator or directs local liaison to work with TIS to manage PHS database.
• Directs the development of associate work schedules to ensure cost effective staffing that meets customer requirements.
• Represents Director in problem resolution when Director is unavailable.
• Manages team projects by empowerment and collaboration of team members:
• Fosters interdisciplinary collaborative relationships within area of responsibility and the Ministry Organization/Region that promotes active participation.
• Provides operational guidance and direction to assigned staff to ensure service integration, effective coordination of departmental work activities, and quality job performance.
• Elicits feedback from interdisciplinary team, including the medical staff, and involves them in decision-making as appropriate.
• Serves as primary liaison regarding scheduling activities and related database issues; issues related to medical necessity/appropriateness of service; and issues related to medical order processing.
• Serves as primary liaison regarding Pre-Service/Financial Clearance functions and related system performance issues; issues related to 3rd party payer requirements.
• Subject matter expert for developing training materials, systems, procedures, and new programs.
• Leads the redesign of Patient Scheduling, Pre-Service/Financial Clearance and intake processes and systems to improve service, data integrity, and staff productivity/quality to achieve departmental goals and process outcomes.
• Develops effective decision-making, communications and interpersonal relations to ensure a positive image of the Ministry Organization, and to ensure customer satisfaction, supporting and portraying strong customer service philosophies in all encounters:
• Manages timely and professional follow-up to customer complaints and issues; and
• Ensures problem resolution and corrective action for long-term solution, coordinating such effort across intra and inter-departmental channels.
• Formally assesses the developmental needs of the division on a periodic basis and promotes opportunities for division development with attention to skills in independent decision-making, effective communications and interpersonal relations to ensure customer satisfaction in conjunction with Trinity Health's core values and to foster team spirit.
• In coordination with the Director, identifies and implements opportunities for staff to increase their knowledge base, advance their practice and enhance their professionalism through staff orientation and continuing education opportunities.
• In this context, the incumbent may manage some degree of training to meet these goals.
• Maintains work site in full operational order:
• Supports the ordering of supplies and other materials in compliance with budgetary constraints;
• Maintains a neat, orderly work environment that denotes professionalism and efficiency; and
• Manages the development of job aides to assist the staff in performing work assignments.
• Selects employees based on potential contributions, departmental culture/needs and personnel policies. Recommends allocation of resources based on scope of goals and priorities.
• Responsible for hiring employees as needed and terminates positions when necessary.
• Monitors and reviews performance appraisals.
• Manages regular ongoing performance feedback cycle based on error reporting, call monitoring, and observation; performs associate evaluations; reviews and approves performance goals:
• Provides feedback in a prompt, direct and positive manner; mentors and coaches associates to ensure positive outcomes;
• Conducts performance evaluations;
• Provides counseling and/or conflict resolution regarding unresolved performance issues, demonstrating effective use of the disciplinary process; and
• Establishes a written developmental plan with clear expectations and subsequent consequences.
• Assists the Director in maintaining fiscal accountability for assigned area of responsibility by identifying new operational, capital and program needs, managing staffing allocation in alignment with customer service goals, and by meeting budget parameters.
• Analyzes and displays data in meaningful formats; Develops and communicates Policies/Procedures and other business documentation; Manages and conducts special studies and prepares management reports, including Key Performance Indicators as they relate to the division (waiting/service times, staff productivity, accuracy, customer feedback, Incident Reporting, etc.).
• Other duties as needed and assigned by the Director.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health's Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Minimum Qualifications:

• Must be willing to travel approx. 2% of the time for onsite meeting in Muskegon, Michigan.
• Must possess a demonstrated knowledge of patient scheduling, medical order processing and medical necessity screening, as normally obtained through a Bachelor’s degree in Healthcare or Business Administration, or a related field, or an equivalent combination of years of education and experience.
• Three to five years of current Patient Scheduling, Registration, Pre-Service/Financial Clearance, Financial Counseling, Case Management/Utilization Review and/or clinical experience with documented evidence of performance achievement.
• Three to five years supervisory experience required.
• Experience in a complex, multi-site environment preferred.
• Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems.
• Must be proficient in the use of Microsoft Office business software.
• Medical scheduling experience and extensive customer service background is required.
• Working knowledge of Medical Terminology and CPT4 coding required.
• Medical Terminology and Working knowledge of computer operations and electronic interfaces is required.
• Experience with call center technology is highly desirable.
• Maintains current knowledge of patient scheduling, medical necessity review and registration/intake processes and systems; insurance eligibility/benefit verification, pre-certification/authorization, referral management and pre-service collections processes and systems; regulatory and 3rd party payer issues and requirements.
• Must become familiar with local charity policy and payment options.
• Demonstrated ability to lead and manage a diverse workforce in a learning environment with frequent changes in departmental priorities.
• Ability to communicate and work with patients, physicians, physician office personnel, associates, MO and SSC leadership, multiple direct patient care providers and others in order to expedite the scheduling process.
• Dynamic communication skills (verbal and written) in dealing with trainees, associates, and internal/external customers.
• Ability to negotiate with insurance vendors, medical directors, and 3rd party payers when appropriate.
• Displays ongoing leadership in promoting positive attitudes and ensuring exceptional customer service.
• Capability and flexibility to develop skills needed as a change agent; Ability to form partnerships through consensus.
• Effective critical thinking, problem solving and decision making skills.
• Strong quantitative and analytical abilities to process and display data.
• Flex