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Director Operations CPUP

Job ID: 136446
FT
Media, PA, United States
Jun 6, 2022

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Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

  • The Director of Operations (DOO) serves as a trusted advisor to the department Chair and COO/ACOO who plans, evaluates, leads and directs all day to day clinical activities and operations of the Department. The primary goal of which is to ensure that the department consistently delivers high quality patient care and with the primary goal of delivering high quality patient care and services by:
  • ensuring that all department patient-care-related processes deliver high quality care to patients and their families, that these processes are efficient, effective and streamlined, and are re-engineered when necessary;
  • implementing strategies and tracking, reviewing and analyzing operational and performance metrics to reduce length of stay, and enhance patient experience and optimize patient access;
  • enhancing financial and cost-effective performance;
  • optimizing revenue generation;
  • managing risk and enhancing quality;
  • understanding, monitoring and adhering to regulatory requirements;
  • operationalizing the Department's strategic planning goals and initiatives;
  • promoting data driven decision making.

Responsibilities:

  • Department Strategic Planning & Change Management:
  • Partners with Chair, COO/ACOO, SOM and CPUP Executive Committee in establishing annual strategic priorities, implementation plans and measures of success.
  • Provides input for the development of Department strategic plan and budget. Facilitates this process in partnership with PENN Medicine Strategic Planning Office, entity leadership, SOM Leadership and the University.
  • Participates in the analysis and evaluation of strategic business plans, feasibility studies, market assessment, marketing plans, data gathering, and preparation of business cases on prospective new programs and opportunities for enhancing revenue.
  • Ensures that annual strategic goals are linked to entity’s and leadership’s performance targets.
  • Participates as a member of the Department Leadership in the development of strategic capital and other resource priorities, and manages them to achieve maximum benefit to Department.
  • Proactively develops change management strategy for major organizational activities and programs. Department On-going Clinical Operations:
  • Conceives, designs and implements clinical operations dashboard and metrics to track and report on clinical performance and to foster data driven decision making.
  • Develops policies to reduce cancellations, bumps, no-show rates, and new appointment lag time.
  • Addresses patient complaints.
  • Establishes provider productivity standards in coordination with the Medical Director.
  • Participates in and supports UPHS patient safety initiatives and clinical effectiveness initiatives.
  • Continually assesses operating procedures and takes action to assure continuous quality improvements.
  • Oversees personnel schedules to ensure effective coverage of support staff.
  • Plans, monitors and manages the operations budget to ensure achievement of operational and financial goals.
  • Assures patient flow through completion of required check-in and check-out processes.
  • Oversees daily appointment scheduling and on-site patient experience to ensure physician and patient satisfaction.
  • Oversees the efficient, effective flow of materials to continuously improve the delivery of quality patient care and customer satisfaction.
  • Ensure that all regulatory requirements are met.
  • Ensures effective utilization of tools, materials, staff and financial resources.
  • Patient Care Processes: (In partnership with, UPHS and SOM Leadership)
  • Ensures all Department facilities and environments of care are clean, safe and patient friendly.
  • Ensures all outsourced services meet agreed upon service standards in support of all patient care processes.
  • Supports the creation of clinical effectiveness targets, improvement plans and reporting systems to ensure the delivery of high quality, effective and efficient patient care.
  • Ensures that teams and individuals have the clinical, informational and organizational tools to serve our patients and customers effectively and efficiently.
  • Oversees physician revenue generation and third party regulatory compliance through application of standardized financial counseling.
  • Oversees physician services cost analysis, focused on identifying and managing physician productivity.
  • Facilitates open sharing of practice management and physician productivity data.
  • Develops and provide access to statistically valid benchmarking data.
  • Provides decision support tools and analytic support through use of CPT data.
  • As one representative of the Department, participates in financial negotiations with third parties, hospital and managed care organizations.
  • Directs complex organizational and financial problem-solving and analyses as related to physician services productivity, reimbursement, ICD-9, CPT and HCFA coding, compliance documentation, and site-specific professional, technical and global fee billing.
  • Performs impact analyses of actual or proposed changes in payment methodologies, i.e., APC, MAPS, RVU updates, fee schedules.
  • Manages insurers’ QA Audits and represents department with any necessary responses
  • Monitors work product and provides reimbursement support and A/R performance of CBO.
  • Schedules and oversees education programs for physician and support staff on reimbursement issues, including appropriate procedure and diagnosis coding, as well as appropriate record documentation needs and techniques.
  • Develops practice management profiles measuring physician productivity, compensation and incentive planning, billing and coding compliance, workforce planning, revenue and payment forecasting, budget formulation and management.
  • Workforce Planning:
  • Is responsible for Human Resource function for select UPHS staff positions; this includes job posting, submission of position justification, performance management, and ensuring mandatory education compliance.
  • Manages approximately eight direct reports, and is responsible for recruitment, evaluation, training, and development of these positions.
  • Administers talent management initiatives for current and future staff.
  • Creates and implements succession plans for critical positions.
  • Implements and oversees the following staff functions: recruitment, development, retention
  • Regulatory Compliance: (In partnership with CPUP, SOM and University)
  • For all University, UPHS and SOM staff within the department, ensures that all areas of accountability are compliant with all federal, state and local regulatory standards and requirements, including JCAHO, Department of Health, funding agencies, FDA, HIPAA, HCFA, DPW, department specific NIH guidelines and others.
  • Acts as department Liaison with CPUP Outpatient Audit, reviews and assesses CPUP findings, resolves any issues, and provides remedial training for identified physicians.
  • Manages insurers’ QA Audits and represents Department with any necessary response.
  • Reviews, implements and ensures compliance of regulatory and legislative changes for all third parties.
  • Acts as Department Liaison and oversees routine audit of billing in accordance with established UPHS guidelines.
  • Medical Records:
  • Is responsible for the development, implementation and maintenance of policies and procedures to ensure efficient processing of information.
  • Oversees chart review process and conducts on-going assessment of documentation to insure compliance with regulations and policies.
  • Ensures compliance with HIPAA, record filing practices, and all related policies.
  • Department Information Systems:
  • Facilitates the development of a technology infrastructure and plan for the Department in partnership with UPHS and SOM CIO.
  • Is responsible for systems management including maintaining the network, designing and, or implementing programs, and upgrading equipment processes as required.

Credentials:

  • LEAN or SSBB

Education or Equivalent Experience:

  • Bachelor of Arts or Science (Required)
  • 10+ years including Direct management experience – minimum 5-7 years. Health care management experience preferred - at least 2 years (Required)
  • Basic understanding of CPT and ICD-9 coding, third-party payer billing processes, pre-certification requirements, and the overall revenue cycle Solid understanding of the purchasing cycle (quote, requisition, purchase order, invoice, payment) and experience using ordering systems (Required).
  • Master of Arts or Science
  • MBA or MHA Leadership experience in a large integrated healthcare delivery system that uses an integrated practice management software system to register, schedule and bill patients.

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

   Current UPHS employees must apply HERE
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