Job Abstract

This position is responsible for the overall management of pre-arrival operations for the USC Health System, including strategic planning, capital and operational budgeting, financial analysis, key metric development and management, regulatory compliance, problem resolution, personnel management, performance improvement, and system improvement and optimization. Pre-Arrival operations may include, but are not limited to pre-registration, insurance verification, securing authorizations, patient estimates, price transparency, billing, pre and post claim edits, denials for hospital and physician services, and pre-authorization. In addition, the Director of Pre-Arrival have oversight responsibility of leaders who manage the daily operations of the Pre Arrival Unit. This position will analyze, recommend, and implement policies and procedures that drive efficient and effective practices and workflows that support the financial clearance of patients and diligently work to minimize patient delays and cancelations throughout the enterprise. They are responsible for analyzing technology improvements and enhancements to minimize rework and silos or redundant processes as it relates to Pre-Arrival Operations. This position will continually collaborate with senior clinical department leaders and with on-site Admitting and registration staff to ensure service is consistent, thorough, and aligned to meet the operational goals of "Patient First" to support industry leading Revenue Cycle and ambulatory clinic operations.

Essential Duties:

• Oversee all pre-arrival operations, including but are not limited to pre-registration, insurance verification, securing authorizations, patient estimates, price transparency, billing, pre and post claim edits, and denials for hospital and physician services.
• Strategic Planning: • Analyze planned and sentinel events to develop strategies for improvement. • Routinely evaluate industry and market forces to provide recommendations for new and/or evolving business development and/or improvement in efficiency and effectiveness of operations. • Manages on-going operational evaluation, reporting to metrics and standards consistent with established goals and target outcomes. • Evaluate ongoing root-cause and take immediate actions to prevent recurrences. • Drive for minimized patient delay and cancellations as processes failure points which are to be prevented. • Evaluation of the current financial clearance technology stack to provide strategic guidance for enhancing the streamlined processing of accounts.
• Oversee Leaders who manage Pre-Arrival team processes and workflow to ensure 100% of account accuracy of patient demographics, all required account fields, validation and verification of insurance coverages, authorizations and patient contact and pre-service collections.
• Prepares and administers assigned budgets; monitors, evaluates and approves expenditures within limits of authority; analyzes staffing needs; performs cost/benefit analyses as appropriate; plans and estimates future costs including capital expenditures as appropriate; justifies requests for equipment and staff.
• Partner with Keck Medicine of USC and USC Care leaders to understand and plan for supporting future system growth needs from Pre-Arrival
• Coordinate with Clinical Department leaders to communicate Pre-Arrival’s support model and scope to plan for the transition of services when mutually agreed upon
• Performance Improvement: • Develop, monitor, and report metrics. Set goals and objectives. • Develop and implement processes and procedures to reach and exceed goals. • Actively participate and collaborate among entities and departments promoting performance improvement and patient satisfaction. • Prioritize and communicate initiatives. • Maintain subject matter expertise in all information systems necessary to lead, implement, and support business processes. • Prepare and report performance improvement initiative data.
• Develops, recommends, revises and implements policies and procedures for assigned programs and services to ensure their consistency with hospital standards and requirements. • Maintain knowledge of state/federal regulations, laws and guidelines that impact Pre-Arrival services • Develop effective internal controls that promote adherence to applicable state/federal laws, and the program requirements of accreditation agencies and federal, state and private health plans. • Seek advice and guidance as necessary to ensure proper management and subject matter understanding
• Leadership: • Selects, trains, evaluates, and counsels management personnel fostering a positive, supportive culture that minimizes employee turnover. • Establishes departmental goals and priorities. • Create and maintain work plans providing timely and relevant feedback to supervisors and subordinate employees.
• Collaborate with clinical administrators, clinical departments, hospital administration, medical staff and all other key enterprise stake holders to enhance patient satisfaction and effectiveness of the pre-arrival services.
• Performs other duties as assigned.

Required Qualifications:

• Req Bachelor's degree Degree in a related field.

• Combined work experience and education as equivalent

• Req 7-10 years Progressive supervisory/management experience in hospital Revenue Cycle and Patient Access departments.
• Req Detailed knowledge of California health care and extensive skills of contracts, insurance and authorizations.
• Req Effective interpersonal and communication skills,
• Req Ability to adapt to multiple and changing priorities,
• Req Working knowledge of managed care, (i.e. Medicare, Medi-Cal, Anthem other commercial payors and all related federal and state regulations and requirements)
• Req Knowledge of government and insurance payors admission and billing regulations
• Req Ability to learn and work with various computer software programs as well as the ability to manage software projects.

Preferred Qualifications:

• Pref Master's degree Degree in a related field.
• Pref Proven leadership experience developing and implementing functional operations plans.

Required Licenses/Certifications:

• Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

USC is an equal opportunity, affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC will consider for employment all qualified applicants with criminal histories in a manner consistent with the requirements of the Los Angeles Fair Chance Initiative for Hiring ordinance. We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at (213) 821-8100, or by email at uschr@usc.edu.  Inquiries will be treated as confidential to the extent permitted by law.

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