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Open Date 10/30/2020Requisition Number PRN24648BJob Title PS Dir, Healthcare/ClinicalWorking Title Director, Clinical Revenue Integrity & Primary Care OperationsJob Grade IFLSA Code ExecutivePatient Sensitive Job Code? YesStandard Hours per Week 40Full Time or Part Time? Full TimeShift DayWork Schedule SummaryMonday – FridayVP Area U of U Health - AcademicsDepartment 00848 - Pediatric AdministrationLocation CampusCity Salt Lake City, UTType of Recruitment External PostingPay Rate Range $103,700 - $128,000Close Date 11/06/2020Open Until Filled NoJob SummaryDirects and oversees clinical revenue integrity operations and strategic planning for 21 clinical divisions in the Department of Pediatrics in support of their clinical revenue mission. Directs and oversees healthcare/clinical functions in areas including (but not limited to), clinical operations, outpatient services, scheduling, materials management, program support, and quality assurance for the divisions of General Pediatrics, which includes South Main Clinic, Sugar House Clinic, University Pediatric Clinic, University of Utah Nursery; as well as the division of Physical Medicine & Rehabilitation. Supports the University of Utah’s goals and mission. Participates in preparing division budgets and in setting division goals. Acts as a catalyst between departments, faculty, staff, physicians, clinical representatives, students, and external entities to ensure continuity and quality of service.ResponsibilitiesEssential FunctionsClinical Revenue Integrity:Works collaboratively with Department of Pediatrics leadership to identify and develop strategies to optimize clinical revenue ($150M in charges, $84M in clinical revenue) for over 300 clinical faculty and advanced practice providers working across 21 clinical divisions in the department, ensuring that:oEvery patient encounter is captured in documentation and entered on the correct note type to accurately reflect the complexity of subspecialty pediatric work provided:Clinic visits (in-person)Telehealth visits (virtual)ProceduresInpatient visits/consultsNon-Face2Face and consultation requests (audio)Chronic care managementoDocumentation in the Electronic Medical Record ( EMR ) (iCentra or EPIC ) supports continuity of patient care and contains Current Procedural Terminology ( CPT )-defined elements needed to optimize coding in order to accurately capture the quantity, quality, complexity, and risk of subspecialty pediatric work through CPT Evaluation & Management (E&M) and procedure codes. Documentation should also support best practice in medico-legal protection.Oversees the work of the Clinical Revenue Integrity informaticist and works collaboratively to identify opportunities for streamlining provider documentation processes and platforms in the EMRs (iCentra and EPIC ).Oversees, manages and updates the Clinical Revenue Information provided on the department intranet page.oReimbursement is optimized through regular communication between department and division leaders, faculty, University Medical Billing ( UMB ), and University of Utah Medical Group ( UUMG ) to identify trends and opportunities for improvement, facilitating focused attention and realigning available resources on process improvement.oDocumentation is completed and finalized in a timely fashion, as defined by department policy and hospital standards.oNew clinical care delivery and associated clinical revenue opportunities are identified, strategized, and implemented.oPolicies, procedures and best-practice processes are developed and followed to support a system focused on ensuring up-to-date knowledge and compliance with state licensing, Centers for Medicare & Medicaid Services ( CMS ), and clinical revenue-specific regulations and standards at the federal, state, university and department levels.oAll providers are properly licensed in states where they practice, and enrolled with relevant 3rd party payors.oClinical revenue data, key performance indicators (KPIs), updates, and analyses are provided regularly to department leaders and decision-makers: tracks goals, identifies areas for improvement, and develops strategies for improvement.Supports each division within the department in their clinical revenue mission and goals:oCollaborates with division managers and chiefs to identify clinical revenue goals, trends, opportunities and areas for improvement. Provides education, tools, and other support as needed.oMentors new managers and new division chiefs in department clinical revenue strategies, processes, and available resources.oDevelops reports and tools to track division-specific clinical revenue metrics and KPIs, including comparing faculty clinical productivity metrics to national benchmark standards.oOversees the process of provider licensing and 3rd party payor enrollment by working closely with the department HR Enrollment specialist, division managers, UMB , and UUMG /Provider Relations Contracting ( PRC ).oWorks collaboratively with HR Enrollment specialist and division managers to track deficient notes; develops strategies to improve provider compliance to department guidelines.Collaborates regularly with UMB and UUMG / PRC :oWorks collaboratively with UMB team to develop systems, processes, reports and communication/education strategies to optimize clinical revenue opportunities and ensure compliance to all documentation and coding standards.oMeets regularly with UMB team and division chief/manager and serves as a liaison between the two groups; reviews KPIs, audits, ensures compliance, and identifies challenges, opportunities and strategizes solutions to 3rd party payor issues.oWorks collaboratively with UUMG and their Provider Relations Contracting Office as a department liaison to identify opportunities and strategize solutions for 3rd party payor contracting challenges.Primary Care Operations:Develops and implements customer service, staffing and financial objectives for the divisions of General Pediatrics, Physical Medicine and Rehabilitation, and Adolescent Medicine that are consistent with the goals and objectives of the University of Utah, Department of Pediatrics, and Primary Children’s Hospital.Manages division budgets, estimates budgetary requirements for special projects and oversees purchases and inventory.Implements and administers new and existing department programs and services to internal and external customers. Evaluates program effectiveness. May carry out and implement logistic plans and procedures to ensure that internal university and external entities’ needs are met.Provides strategic direction by setting short and long-term goals, estimating budgetary requirements for staff, space and equipment planning, and implementing special projects and policies. Establishes internal objectives and implements procedures to meet goals. Develops strategies consistent with continuous quality improvement programs.Oversees all aspects of staff management including recruitment and retention of assigned staff. Ensures competency of management and supervisory staff through the development and presentation of educational programs and through on-going staff performance evaluation.Ensures customer and patient satisfaction by analyzing customer complaints, concerns and suggestions. Provides appropriate follow through to ensure quality customer service.Oversees the analysis and determination of appropriate staff mix to support patient needs.Participates in Primary Care Operations meetings/committees at the University level, such as Primary Care Integration, Patient Centered Medical Home, etc.Markets and promotes new and existing programs and services to internal and external customers.Facilitates cooperative and collaborative relationships with the community and other institutions.Serves as part of the department management team.DISCLAIMERThis job description is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.Work Environment and Level of Frequency typically requiredNearly Continuously: Office environment.Physical Requirements and Level of Frequency that may be requiredNearly Continuously: Sitting, hearing, listening, talking.Often: Repetitive hand motion (such as typing), walking.Seldom: Bending, reaching overhead.Minimum QualificationsBachelor’s degree in Business Administration, Health Care Administration or related area, or equivalency; eight years of progressively more responsible management experience; and demonstrated leadership, human relations and effective communications skills required.This position is patient-sensitive and must fulfill all associated requirements. We protect our patients, coworkers and community by requiring all patient-sensitive employees to be immunized according to CDC standards and hospital policy. Limited exemptions may be made for documented medical contraindications or religious beliefs that object to vaccinations.Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.PreferencesMaster’s degree in Healthcare Administration, Public Administration, Business Administration or other related field.Comprehensive experience and understanding of clinical revenue and clinical revenue integrity.Minimum of six years of experience in practice management, clinic operations or healthcare administration, preferably in an academic medical center setting.Knowledge of finance, administration, managerial principles, HR, risk management, Joint Commission, Medicaid/Medicare, contracting, practice operations, managed care, and the academic health care environment.Comprehensive understanding of academic medical center environment.Demonstrated leadership and project management skills with ability to effectively motivate team members.Excellent communication, organization, and human relation skills. Excellent decision-making capabilities and thoughtful exercise of judgment.Type Benefited StaffSpecial Instructions SummaryAdditional InformationThe University of Utah is an Affirmative Action/Equal Opportunity employer and is committed to diversity in its workforce. In compliance with applicable federal and state laws, University of Utah policy of equal employment opportunity prohibits discrimination on the basis of race or ethnicity, religion, color, national origin, sex, age, sexual orientation, gender identity/expression, veteran’s status, status as a qualified person with a disability, or genetic information. Individuals from historically underrepresented groups, such as minorities, women, qualified persons with disabilities, and protected veterans are strongly encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law.To inquire about this posting, email: employment@utah.edu or call 801-581-2300. Reasonable accommodations in the application process will be provided to qualified individuals with disabilities. To request an accommodation or for further information about University AA/EO policies, please contact the Office of Equal Opportunity and Affirmative Action, 201 S. Presidents Cr., Rm 135, (801) 581-8365 (V/ TDD ), email: oeo@umail.utah.edu .The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Human Resources at (801) 581-7447 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or University Human Resource Management at (801) 581-7447 if you have questions regarding the post-retirement rules.This position may require the successful completion of a criminal background check and/or drug screen.The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Human Resources at (801) 581-7447 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or University Human Resource Management at (801) 581-7447 if you have questions regarding the post-retirement rules.This position may require the successful completion of a criminal background check and/or drug screen.
