Brea, CA, US
2 days ago
Director of Patient Care Operations

About Us: Infusion For Health is a rapidly expanding private-equity-backed healthcare provider specializing in infusion therapies for chronic conditions. We are dedicated to improving the lives of our patients through exceptional care and innovative treatments. As we continue to grow throughout California and beyond, we are seeking talented and motivated individuals to join our team.


Position Overview: This pivotal role will be instrumental in driving rapid, sustained and scalable performance for multiple service functions, ensuring exceptional patient care operations, operational efficiency, and regulatory compliance. Scope of role includes oversight of patient intake department, including insurance eligibility, authorization and scheduling. Also includes verification and authorization for returning patients, and inbound call support. The successful candidate will demonstrate exceptional leadership skills, strategic planning capabilities, and a track record of driving innovation and change management.


DUTIES AND RESPONSIBILITIES

Set, measure, deliver on and communicate key performance metrics (KPIs). Set goals and timing, and communicate results to team and other internal stakeholders. Set new goals as existing ones are met and exceeded.Take ownership for achieving goals; problem solve and execute where needed to overcome obstacles or setbacks.Set and monitor secondary metrics as needed to assess and manage performance (e.g., individual productivity, quality); coach as needed.Identify, prioritize and execute plan to achieve KPIs and priorities. Can include process / workflow changes, tools, coaching or performance management, and/or collaboration with other functional areas or external stakeholders. Includes significant partnership with Revenue Cycle and Sales functions.Build an intimate knowledge base and understanding of all aspects of the department, including patient experience and insurance related processes. Includes Intake workflow, tools, and personnel, as well as upstream and downstream processes.Effectively drive employee performance and engagement. Hire, oversee training, set expectations, evaluate and coach personnel.Drive performance in additional overseas partner team to meet business and core-US team goals.Ensure team staffed appropriately, including build and utilize staffing model.  Foster a positive, professional and collaborative work environment.Maintain a comprehensive understanding of best-in-class available and emerging tools and services in the market to support area, as well as those already available through existing third-party vendor relationships and platforms.Own successful implementation of new capabilities / services / tools, including set upfront expectation of impact and timing, and deliver against those goals. Build and utilize additional analysis and/or reporting where needed; preference for use of automated reporting for recurring needs. Ability to identify and run analysis to improve understanding of function and identify opportunities, or track results. Collaborate with IT function for support where needed.Maintain compliance with regulatory and payor requirements, guidelines and established policy. Stay updated on insurance policies, guidelines, and industry regulations to ensure continued compliance.Create, develop, and implement Policies and Procedures or work instructions where appropriate.Keep direct supervisor informed of work progress, timetables, and issues.Maintain strict compliance with State, Federal and other regulations (e.g., OSHA, WC, HIPAA, ADA, FEHA, DOL, HR policies and practices).

 

SKILLS/ABILITIES:

Results driven; allocates time and energy on key drivers in a fast-paced environmentAbility to prioritize tasks and projects with limited direction, while understanding and contributing to the success of the organizationAble to effectively problem solve new challenges, and support team to solve issues as neededDisplay independent judgment by willingness to make timely and accurate decisions based on available information that is sometimes limited in natureStrong research and auditing skills, and high curiosity to understand root cause and design solutions to prevent recurrenceClearly communicate to team members; hold accountable and also recognize and celebrate successAppropriately delegate authority and responsibility, and hold team members accountablePlan for future needs (6-12 months) to anticipate potential obstaclesDetail-oriented, organized and process focused; self-motivated and proactive

 

EDUCATION & EXPERIENCE

4+ years of experience in leading a team of  in a healthcare organization; experience in insurance-driven function preferred.Strong understanding of Medicare, Commercial, and Medicaid regulationsProven expertise in service-focused operations
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