Inspire health. Serve with compassion. Be the difference.
Job Summary
Manages the business administration of the Medical Group in support to the
Prisma Health mission and goals. Develops internal departmental resources,
utilizes Admin support, and accesses Prisma Health corporate services as
appropriate to maintain accountability for areas outlined below.
The Practice Operations Manager is an integral leadership role for Blount
Memorial Physician Group. This position reports to the Director of Medical Group
Operations and has responsibility for multiple clinic locations and specialties
including approximately fifty providers and over 100 team members and growing.
Essential Functions
* All team members are expected to be knowledgeable and compliant with Prisma
Health's values: Inspire health. Serve with compassion. Be the difference.
* Develops, monitors, and manages annual fiscal budgets. Prepares ad hoc
financial reports. Responsible for the intra-departmental control of
corporate assets and the effective/efficient management/utilization of
clinical department resources. Facilitates responsible decision making to
balance fiscal and academic missions. Coordinates and establishes the annual
capital budget in accordance with equipment needs and the department's
business plan.
* Liaison between clinical department and University Medical Group Leadership
and responsible for accurately conveying related communications to physician
faculty and staff in a timely manner. Responsible for communicating
corporate goals, decisions, and operating guidelines to service line staff.
Participates in the development and implementation of the annual marketing
plan in coordination with the system's strategic direction. Ensures that all
internal and external communication material appropriately reflects the
mission and values of Prisma Health. Actively engaged in providing regular
flow of clinical department information to formal communication plan effort.
* Recruits and selects appropriate staff within the constraints of approved
budgets. Trains employees on policies and procedures of department and
Prisma Health. Evaluates and monitors work performance of designated staff.
Counsels, disciplines, and terminates designated staff as necessary.
Establishes productivity standards for support staff and monitors their
adherence. Ensures the establishment of employees' annual performance
goals. Prepares and conducts timely and appropriate performance appraisals.
Ensures that all positions have accurate, valid position descriptions on file
and that employees are familiar with the position description and the
standards of performance. Ensures that the program operates in an
environment where all employees are treated fairly and in accordance with
policies and procedures.
* Measures and understands reimbursement by payer, by procedure code, for
services rendered by the department. Measures and understands physician
clinical productivity levels rendered against national norms by provider.
Measures and understands appropriate staffing levels for services provided
against national practice management benchmarks (ACMPE, MGMA, AAMC).
Measures financial performance of clinical department via regular review of
and formal comment upon monthly departmental income statements as well as
other financial reports as deemed appropriate.
* Participates in review of terms, plan requirements, and reimbursement rates
of potential managed care contracts. Effectively utilizes Legal and
Contracting Department in negotiation of all non-insurance related contracts,
i.e., lease agreements, equipment purchase/rental, external consulting
services, etc.
* Directs the daily business and clinical functions of the practice while
serving in a leadership role for the clinical department to ensure its smooth
operation within the strategic plan and mission statement in coordination
with the Director, Medical Group Operations and the Administrator.
Efficiently manages billing processes "front office functions", within
parameters established by regulations (i.e., including charge capture,
coding, documentation, claims processing, demand billing, payment posting).
Works with Reimbursement Department to review diagnosis and procedure codes
utilized by the department to ensure greatest reimbursement while maintaining
compliance with regulatory guidelines. Works with Reimbursement Department
to maintain knowledge and expertise in billing related matters associated
with department specialty and communicate pertinent information to staff and
physicians. Responsible for all clinical department practice management
functions including charge capture compliance, pre-certification and other
effective billing practices. Registration, insurance verification,
reimbursement and, collections. Monitors the registration process to ensure
efficient patient access and flow to and from practice. Ensures the
resolution of third-party reimbursement issues by working with
Administration, Reimbursement and Managed Care Departments' staff
respectively to maximize reimbursement within the limits defined by law.
Maintains a working knowledge of third-party payment practices, including (as
applicable) Medicare, Medicaid, managed care organizations, private insurers,
worker's compensation carriers and occupational medicine payment practices.
Works with managed care department to assist their contract negotiations with
third party payers and managed care organizations. Analyzes the financial
impact of managed care contracts for clinical department. Participates in
the recruitment and selection of physician personnel. Ensures payroll is
prepared and submitted in accurate and timely manner. Ensures compliance by
all employees with time and attendance guidelines. Analyzes data to project
staffing needs and ensure adequate staff coverage in all areas. Initiates,
develops, implements, and maintains clinical department practice management
procedures to ensure operational effectiveness and compliance with policies
and procedures and the system's Code of Excellence. Assists in any follow-up
necessary to ensure prompt payment.
* Solicits feedback on overall satisfaction from clients and referral sources
through satisfaction surveys. Evaluates feedback and makes recommendation
for change to address identified issues. Establishes processes to identify
new or improved services to meet client needs and implements those services
where appropriate. Measures quality indicators such as cost effectiveness,
efficiency and outcomes data on a regular basis. Report measurements of
quality indicators to staff as well as the Director, Medical Group
Operations. Responsible for leading the physician practice component of JCAHO
reviews for their respective clinical department practice locations. Ensures
compliance with regulatory and accreditation agencies. Ensures the
coordination of clinical procedural changes, new program development,
standards of care and ongoing activities with the Director, Medical Group
Operations.
* Performs other duties as assigned.
Supervisory/Management Responsibilities
* Job has direct and/or indirect supervision of employees that may include
final budget authority, hire/termination/disciplinary authority, performance
appraisal responsibility. Job will be considered a member of the management
staff with direct reports.
Minimum Requirements
* Education - Bachelor's Degree in Healthcare management, Clinical Field,
Business/Finance or related field of study. Master's degree Business or
Healthcare preferred
* Experience - Five (5) years in physician practice management
In Lieu Of
* Bachelor D. plus five (5) years of Prisma Health experience in Personnel
Mgmt., Finance or Operations; OR
* Bachelor D. plus three (3) years in physician practice management, personnel
mgt, finance or operations; OR
* Masters D plus three (3) years of a combination of Prisma Health and UMG
physician practice management, personnel mgt, finance or operations; OR
* HS Diploma plus ten (10) years of experience in physician practice
management, personnel mgt, finance or operations including three (3) years
healthcare management experience.
Required Certifications, Registrations, Licenses
* NA
Knowledge, Skills and Abilities
* NA
Work Shift
Day (United States of America)
Location
Blount Memorial Hospital
Facility
BMPG Joule Street Alcoa
Department
Administrative and General
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