As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

JOB SUMMARY

Manage the daily operations of a Patient Access department to effectively implement process improvements and ensure the safe, timely, accurate processes of patients through the Patient Access flow.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Implement process improvement initiatives as directed and needed to achieve both Conifer and Client goals. Continuously focused on meeting metrics and proactively identifying areas of opportunity by working collaboratively, professionally and fostering positive relationships with both internal and external peers.
• Develop and implement action plans as identified.
• Actively practice budget/cost management.
• Understand and be able to speak to all aspects of Patient Access, from technology, processes and regulations.
• Consistently manages staffing activities in areas of responsibility. This includes documentation and identification of needs, selection of staff, wage/salary activities, orientation and training. Grow/Mentor supervisors and ensure staff engagement and commitment to strategy, mission and goals. Communicate proactively and positively with direct supervisor to ensure personal growth in knowledge and skill set.
• Work positively with Client Services to ensure that client needs/concerns/requests in relation to Patient Access are being addressed proactively and in a way which does not negatively impact efficiencies or operational flows established.
• Effectively and proactively communicate and address issues that may be impeding performance, including technology or processes.

FINANCIAL RESPONSIBILITY/SCOPE (Specify Revenue/Budget/Expense): Varies based on hospital size, volume and payor mix.

• Bed size: 300+

OR

• Points of Entry: 8+ (clinic/satellite is 1 POE)

OR

• Number of facilities: 2-3 mid-sized hospitals or multi-site]

AND

• $200M+ in Net Patient Revenue

SUPERVISORY RESPONSIBILITIES

This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

• Direct Reports (titles) Manager or Supervisors, Patient Access
• Indirect Reports (titles) Rep, PA I-IV; Rep, PA Scheduler

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Knowledge of Medical Management regulations that fall under CMS, URAC, NCQA, and other applicable state and accreditation standards.
• Commitment to service excellence and member satisfaction.
• Ability to develop and maintain effective working relationships with other teammates, members and clients.
• Ability to multi-task in a fast-paced clinical setting.
• Excellent verbal, written and interpersonal communication skills.
• Ability to relate to culturally diverse patients and community.
• Ability to develop positive interaction with patients, families, physicians, administrators and teammates in order to effectively care for the patient.
• Aptitude for coaching, training and developing new teammates.
• Ability to build strong relationships across multiple functional lanes.
• Ability to analyze and interpret data to show outcomes and/or focus area for improvement
• Strong communication, team leadership and project management skills.
• Ability to collaborate and build strong client relationships across all levels of the organization including clinical staff, physicians and administrative leadership to meet deliverables.

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

• 10+ years of professional experience required; minimum 10 years experience overseeing medical management operations for health plan, management services organization, and/or health plan.
• Externsive utilization management (prior authorization / concurrent review) and case management experience
• Extensive experience managing budget of $5M+ with demonstrated ability to drive productivity and outcomes
• Demonstrated experience designing and implementing new programs
• Experience in business-to-business client service organization preferred
• Experience providing strategic leadership, managing teams and leading projects required.
• At least 5 years management experience with large, geographically disparate teams

REQUIRED CERTIFICATIONS/LICENSURE

Include minimum certification required to perform the job.

• Bachelorâ��s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college.
• Case Management certification preferred
• MSW/MBA/MPH/MHA preferred
• Active RN or MD License
• Driverâ��s License

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to work in sitting position, use computer and answer telephone
• Ability to travel
• Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Office Work Environment

TRAVEL

• Approximately 50% travel may be required

Employment practices will not be influenced or affected by an applicant�s or employee�s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.