Manager Patient Access

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

Responsible for the management of scheduling, insurance authorization and referral services for Dignity Health Revenue Cycle assigned facilities. Ensures patient demographic and financial data is collected at the point of care and/or scheduling and orders are compliant with hospital and regulatory guidelines. Ensures authorizations are processed in a timely manner for all scheduled and non-scheduled procedures at Dignity Health Revenue Cycle assigned facilities and referrals are in place for all Physician Enterprise specialty practices according to payer guidelines. Provides first level application support and maintenance for all applications utilized by the departments.

Develops and fosters a professional working relationship with hospital, senior managers, Practice Managers, Administrators, department heads and members of the staff. Develops and maintains effective relationships with Patient Access, Health Information Management, Patient Financial Services, Information Systems, ancillary departments, physician office staff, third party payer personnel, etc.

The following are representative of the duties and responsibilities the Patient Access Manager, Outpatient Services/Ins Auth-Referral 

Manages assigned staff, assessing staffing needs on a daily basis and verifying all processes are being completed in an accurate and efficient manner.
Ensures efficient flow of scheduling, pre-registration and authorization review for various locations as assigned to ease the way for patients and to ensure that departments and clinics are not hindered by the  process.
Ensures all patient demographic and financial data is being collected as required.
Coordinates work-flow processes and serves as a liaison for the Scheduling and Patient Management applications.
Maintains a complete and thorough understanding and knowledge of all scheduling, pre- registration, authorization and referral applications.
Maintains a working knowledge of all assigned application structures and operating practices. Understands each application’s purpose and how it supports the scheduling, pre-registration and authorization workflow.
Establishes and maintains a system that ensures scheduling, pre-registration and the authorization/referral process is accurate relative to data integrity indicators in an efficient manner
Uses technical knowledge to support Patient Access department and Physician Enterprise management and staff to ensure consistent understanding of established operating practices related to scheduling, authorizations and referrals.
Maintains knowledge of current policies, procedures and payer guidelines as well as maintains expertise and proficiency in all Patient Access technologies.
Reviews patient orders to ensure they are compliant and support medical necessity for authorization and referral requirements and registration accuracy,
Maintains a good working relationship with physician offices and community members.
Coordinates training programs designed to maximize the knowledge and professionalism of all staff members that access and utilize the authorization and referral applications for both acute and ambulatory sites.
Provides direct supervision of the scheduling, insurance pre-registration, authorization and referral staff.
Supervises the orientation of new employees and the ongoing training of all personnel in the department to ensure competency.
Develops measurable performance objectives related to the quality of scheduling activities.
Hires, leads, coaches, counsels and mentors staff for ongoing development and performance excellence.
Provides regular feedback to the Director of Patient Access on employee development/progress.
Develops and administers a department staffing schedule. Ensures PTO is submitted and entered into the time and attendance system accordingly.
Directs and/or participates in inter-departmental Task Forces and committees as required.
Maintains relevant statistical information to assist in performance indicators and other departmental needs.
Assumes responsibility for the operations of the department in the absence of the Market Manager

Bachelor’s degree in business or related field and three years in Patient Accounting, Patient Access or Patient Scheduling in a healthcare environment with broad knowledge across all areas. An equivalent combination of education and/or experience may be considered.
Three years of experience in a leadership role with demonstrated ability to manage performance, coach and develop staff and build strong teams.
Must be familiar with all types of Patient Access office activities and processes, including, but not limited to, Admitting, Pre-admitting Insurance Verification, Scheduling and Insurance Billing.
Certified Healthcare Access Manager (CHAM) certification preferred.
Knowledge of third-party payer requirements including federal, state and private health care plans and authorization processes.
Demonstrates professionalism, credibility and commitment to high standards.
Excellent communication, interpersonal, public relations, leadership and team-building skills.
Must be a self-starter who is accountable and requires minimal direction and supervision.
Must be creative, flexible, open to new ideas and able to adapt to change quickly and smoothly.
Advanced computer literacy and proficiency in Microsoft Windows and Microsoft Office (Outlook, Word, Excel).
Electronic Medical Record (EMR) experience preferred; Cerner strongly preferred; knowledge of system maintenance relating directly to scheduling and/or registration applications preferred.