Job Information
UPMC Director, Operations CCM in Pittsburgh, Pennsylvania
This position will work in within dual systems between UPP CCM and Pitt.
Responsibilities:
Supervise coding and charge entry staff (where applicable). Work with staff to improve revenue process within the BU and solve problems and identify resources related to insurance coverage and reimbursement issues for all BU community based BU.
Create a culture of service excellence focused on defining, understanding and consistently satisfying the requirements of both internal and external customers.
Serve on all committees as assigned. Provide leadership, oversight and direction for assigned special project activities.
Implement, monitor and evaluate all quality initiatives to ensure positive patient outcomes. Oversee patient access and patient satisfaction initiatives. Facilitate processes to improve patient satisfaction. Ensure continuity of care for patients evaluated and treated by physicians, including timely communication with patients and referring physicians.
Assist managers and division chiefs to develop and implement action plans to improve service levels and exceed customer expectations.
Develop operating and capital budgets for BU may include, but not limited to, PSD, School of Medicine and hospital. Ensure that BU meets budget goals. Assist with the supervision and oversight of the BU budgets (i.e., clinical practice plan, hospital, School of Medicine, and research). Assist the Administrator by maintaining financial records/reports used to monitor and analyze performance against goals.
Responsible for the charge lag process ensuring the business unit (BU) professional fees are entered into the EPIC systems within established timeframes. Serve as a BU resource in developing strategies to maximize reimbursement and disseminate regulatory information pertaining to changes in reimbursement and/or coding while ensuring regulatory compliance.
Manage the human resources functions for the BU including recruitment, performance evaluations, and corrective action regarding staff within the BU which may include, but not limited to, PSD, School of Medicine and hospital. Mentor office managers and staff.
May assist with accredited fellowship program to ensure compliance with required training components and may act as liaison with GME department.
Create and implement business and program development plans that support and advance the BU and hospital strategic initiatives. Assist faculty and coach staff to establish and achieve programmatic goals.
Oversee all contracts and lease agreements for BU. Provide direction and support to the BU management staff for clinical purchasing (pharmaceuticals, laboratory supplies, med-surgical supplies, equipment, etc.) Work with Facilities and Materials Management and appropriate vendors to ensure that practices are provided with cost-effective and high quality products and supplies. May act as liaison to outside vendors.
Act as a consultant to physicians in developing new strategic business opportunities and develop new outreach sites for BU. Provide assistance when opening BU in the community, identify market strategies, growth opportunities and oversee quality and efficiency of outpatient office locations. Ensure BU is in compliance with UPMC policies and procedures and with the requirements of any applicable regulatory agencies or accrediting bodies (i.e. JCAHO, PA Department of Health, Medicaid).
Work closely with Clinical, Administration and Information Services staff in identifying opportunities for improving cost and quality of care through in-depth process and cost of care analysis, forming recommendations to drive significant operational changes.
Coordinate all EPIC activity including training for staff, as required. Create necessary reports in EPIC, specifically those to evaluate physician productivity. Conduct quarterly physician productivity meetings.
Assist in establishing and implementing policy related to BU including, but not limited to, professional licensure, registration and/or certification; risk management; clinical operations and clinical compliance; and staff and patient safety. Identify educational needs of all BU outpatient office staff who provide treatment and care to inpatients as well as outpatients of the physicians. Assist in meeting in educational requirement of staff.
Act as a consultant to physicians in developing new strategic business opportunities and develop new outreach sites for BU. Provide assistance when opening BU in the community, identify market strategies, growth opportunities and oversee quality and efficiency of outpatient office locations. Ensure BU is in compliance with UPMC policies and procedures and with the requirements of any applicable regulatory agencies or accrediting bodies (i.e. JCAHO, PA Department of Health, Medicaid).
Manages day to day operations and establishes criteria for setting organization-wide priorities; defining goals and objectives for selected initiatives.
Responsible for the charge lag process ensuring the business unit (BU) professional fees are entered into the EPIC systems within established timeframes. Serve as a BU resource in developing strategies to maximize reimbursement and disseminate regulatory information pertaining to changes in reimbursement and/or coding while ensuring regulatory compliance.
Develops and maintains operational policies and procedures for various departments and support areas.
Supervise coding and charge entry staff (where applicable). Work with staff to improve revenue process within the BU and solve problems and identify resources related to insurance coverage and reimbursement issues for all BU community-based BU.
Uses internal and external replenishment systems and processes to impact product acquisition and assists in annual review of capital requests.
Maintains organizational focus on quality initiative and results through required performance improvement projects.
Coordinate all EPIC activity including training for staff, as required. Create necessary reports in EPIC, specifically those to evaluate physician productivity. Conduct quarterly physician productivity meetings.
Develop operating and capital budgets for BU may include, but not limited to, PSD, School of Medicine and hospital. Ensure that BU meets budget goals. Assist with the supervision and oversight of the BU budgets (i.e., clinical practice plan, hospital, School of Medicine, and research). Assist the Administrator by maintaining financial records/reports used to monitor and analyze performance against goals.
Create and implement business and program development plans that support and advance the BU and hospital strategic initiatives. Assist faculty and coach staff to establish and achieve programmatic goals.
Assure the development of goals and objectives for assigned areas/departments are in alignment with the mission, vision and values of the hospital.
Create a culture of service excellence focused on defining, understanding and consistently satisfying the requirements of both internal and external customers.
Assist managers and division chiefs to develop and implement action plans to improve service levels and exceed customer expectations.
Oversees new construction, renovation projects and building utilization. Assists VPO in assessing existing needs and plans for new programs and services to support the needs of the Business Unit.
Implement, monitor and evaluate all quality initiatives to ensure positive patient outcomes. Oversee patient access and patient satisfaction initiatives. Facilitate processes to improve patient satisfaction. Ensure continuity of care for patients evaluated and treated by physicians, including timely communication with patients and referring physicians.
Monitors operating statistics and patterns to identify trends and changes across the business unit.
Assist in establishing and implementing policy related to BU including, but not limited to, professional licensure, registration and/or certification; risk management; clinical operations and clinical compliance; and staff and patient safety. Identify educational needs of all BU outpatient office staff who provide treatment and care to inpatients as well as outpatients of the physicians. Assist in meeting in educational requirement of staff.
Participates in developing a corporate culture of patient and staff satisfaction, empowerment, problem solving and accountability.
May assist with accredited fellowship program to ensure compliance with required training components and may act as liaison with GME department.
Conveys courtesy, respect, enthusiasm and positive attitudes with patients, staff, medical staff and visitors.
Oversee all contracts and lease agreements for BU. Provide direction and support to the BU management staff for clinical purchasing (pharmaceuticals, laboratory supplies, med-surgical supplies, equipment, etc.) Work with Facilities and Materials Management and appropriate vendors to ensure that practices are provided with cost-effective and high-quality products and supplies. May act as liaison to outside vendors.
Qualifications:
Bachelor's Degree in Health Care Administration, Business Administration, Finance, Accounting or related field / 5 years of experience
OR - Bachelor's Degree in Health Care Administration, Business Administration, Finance, Accounting or related field / FMR Program Graduate / 3 years of experience
OR - Master's Degree in Health Care Administration, Business Administration, Finance, Accounting or related field / 3 years of experience
OR - Master's Degree in Health Care Administration, Business Administration, Finance, Accounting or related field / Fellowship Program Graduate / 3 years of experience
Advanced knowledge of applicable federal, state, and local laws as they pertain to physician BU management, preferred.
Knowledge of revenue cycle, physician billing, and contracts, preferred. Licensure, Certifications, and Clearances:
Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran