GENERAL OVERVIEW:
Manages the daily operations related to clinical activities for designated sites.
ESSENTIAL RESPONSIBILITIES:
Responsible for the clinical professional services for designated sites.Manage the day-to-day operations and office functions.Supervises staff, resolves problems and implements approved disciplinary action.Interviews, hires, trains and conducts performance evaluations.Manages and monitors key financial and revenue cycle metrics including staff hours, resource allocation, expense budget, patient volumes and the revenue cycle process.Provides primary (or secondary) review of reconciliation of monies being collected and deposited.Responsible for monitoring patient satisfaction reports, identifying variances from standard, addressing and resolving patient complaints.Responsible for quality and performance improvement by monitoring metrics and addressing deficiencies.Implements and coordinates practice performance improvement programs.Perform clinical duties necessary to support site.Works collaboratively with physicians, leadership and health professionals to accomplish organization and practice goals.Ensures compliance with all regulatory requirements.Participates in budget preparation for clinical and operational activities.Establishes policies and procedures related to patient care.QUALIFICATIONS
Minimum
5-7 years of experience in a healthcare setting required or equivalent combination of education and experience.Registered Nurse License required.Bachelors of Science in Nursing required if working in an Oncology setting.Knowledge of medical terminology, insurance theory and ICD-9, and CPT coding required.Preferred
Master’s degree in nursing or related health care field preferred.Professional certification in area of nursing expertise preferred. 1-3 years supervisory experience preferred.Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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