Assistant Director, Pre-Access Operations
Job Summary Under the general supervision of the Patient Access Services Director, The Assistant Director, Pre-Access Operations actively manages all aspects of day-to-day operations of the four Pre-Access business units, including financial, human and other resource management, goal setting, and departmental planning.
The Assistant Director, Pre-Access Operations works closely with fellow Patient Access Services leaders, Patient Financial Services, Case Management, and Health Plan Services to optimize Access operations, maintain excellent quality of work, and secure patient revenue in support of UCSF Health.
S/he has responsibility for developing and maintaining a high standard of patient access to care and a sound patient financial experience. S/he will routinely work closely with clinical department leadership and physicians to ensure efficient processes and effective communication are in place and stakeholder involvement is maximized. Develops and manages relationships with external entities such as insurance companies, medical groups, and state/county offices in order to escalate and resolve barriers/challenges to financial clearance activities.
Actively participate in development of reports, tools, system functionality to improve performance and promote accountability. The Assistant Director will inform on the design and implementation of updates and optimization of patient access workflows in the electronic medical record and other systems through ongoing participation in standing committees and ad hoc performance improvement initiatives.
Working in conjunction with the Director, the Assistant Director will adopt existing policies and procedures and develop customized procedures and programs that respond to changing health care coverage and reimbursement requirements and to patient needs. Establishes department-wide goals, budgets, and staffing plans. The final salary and offer components are subject to additional approvals based on UC policy. Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. The salary range for this position is $113,500 - $258,100 (Annual Rate). To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html Department Description Pre-Access Operations functions (insurance verification, authorizations, financial clearance) for UCSF Health - West Bay are organized to provide services on behalf of a wide-spectrum of inpatient and outpatient clinical departments and clinics. Separate and discrete functional units within Pre-Access Operations include:
- Pre-Admissions Unit: Management of: a) insurance/benefits processing and authorization validation for outpatient/inpatient surgical procedures (>30,000 annually); b) insurance verification and authorization validation for inpatient admissions (>10,000 annually). Responsible for final financial clearance for these services.
- Prior Authorization Radiology (PAR) Unit: Responsible for authorization procurement and benefits verification for radiology imaging services (>65,000 annually).
- California Children's Services (CCS) Unit: Management of a) insurance/benefits and procuring authorizations b) insurance verification and authorization follow up provided by staff and services for all CCS-eligible inpatient and outpatient services.
- Outpatient Access Unit: Management of insurance verification reconciliation for outpatient clinic appointments;
In order to protect and preserve the financial assets of UCSF Health, the Pre-Access Operations Department must apply sound financial management of inpatient and outpatient insurance and authorization processes as it relates to timely and efficient claims submission and payment. Patient financial clearance responsibilities are attributable to the assurance that hundreds of millions of dollars in patient care services will be covered by insurance and reimbursed in a timely manner. Responsibility also includes management and oversight of the ADT/Registration Discharged Not Billed (DNB) claim holds, ensuring that timely review and resolution to maintain no greater than $23 million (charges), on a rolling weekly basis, held for incomplete information associated with inpatient admissions. Responsible for CCS DNB of no greater than $23 million, on a rolling weekly basis, for inpatient and outpatient services held for resolution.
The Pre-Access Operations Department adheres to local, state, and federal guidelines and promotes and supports excellence in patient financial experience and attainment UCSF Health financial goals. Required Qualifications
- Bachelor's degree in related area and / or equivalent experience / training
- Minimum of seven (7) years healthcare management experience
- Thorough knowledge of insurance, scheduling, registration, Authorization / referral, information technology systems, and the policies, principles, and best practices involved with effective patient access services administration
- Strong knowledge of customer service standards; applies organizational skills and knowledge of management techniques to effectively establish and implement priorities, goals, and objectives, and to assess department performance in conjunction with them
- Excellent managerial and leadership skills, with the ability to create and maintain a climate of teamwork and collaboration, effective problem solving and conflict resolution, and adherence to organizational mission and values. Advanced human resources management knowledge
- Excellent communications skills to convey complex information clearly and concisely to all levels of staff and management, as well as outside agencies and individuals
- Ability to motivate, influence, and persuade others
- Ability to ensure that the department exhibits a culture of respect, accountability, and quality customer service to all constituencies
- Excellent ability to quickly evaluate complex problems, identify multiple potential solutions, and effectively implement action plans to bring about successful resolutions
- Ability to work effectively with senior management and executive-level staff across departments, to influence decisions, motivate and persuade others in sensitive situations, and to serve as an informational and educational resource on admissions and registration services and operations
Preferred Qualifications
- LEAN, 5S or/and Six Sigma leader training
About UCSF At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what's possible for the patients we serve - a promise we share with the professionals who make up our team.
Consistently ranked among the top 10 hospitals nationwide by U.S. News & World Report - UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere. In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents. Pride Values UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.
In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu
Join us to find a rewarding career contributing to improving healthcare worldwide. Equal Employment Opportunity The University of California San Francisco is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Job Code and Payroll Title 005771 PAT ACCESS SVC MGR 2 Job Category Executive, Professional and Managerial, Supervisory / Management Bargaining Unit 99 - Policy-Covered (No Bargaining Unit) Additional Shift Details Monday - Friday, 8 a.m. - 5 p.m. |
University of California - San Francisco Campus and Health
Dec 27, 2024