Administrator Access and Navigation en ST JOHNS HEALTH

Description

Job Summary: Function as a member of the Physician Services Leadership Team focused on patient access and navigation. Support implementation of St. John’s Health Strategic Plan initiatives. Carry out patient navigation initiatives in collaboration with clinic administrators, Director of Operations, Director of Revenue Cycle, Marketing, SJH Foundation, Chief Medical Group Officer, Chief Financial Officer.

Essential Functions:

1. Patient Access and Navigation

Develops, implements, and oversees a system-wide comprehensive patient access, navigation, and hospitality system. Includes oversight of remote and in-person patient access resources, front office staffing across all SJH points of entry. Assures consistent training, quality, customer service, and compliance. Oversees referral management program to maximize utilization and scheduling efficiency. Facilitates seamless navigation and scheduling of SJH departments. Collaborates with Director of Revenue Cycle to ensure compliance with access and services including VA authorizations, denial management, Good Faith Estimates (GFEs), insurance verification, and patient cost estimates prior to visits. Evaluates barriers to access across the community and identifies and implements solutions to address access disparities.

1. Clinic Operation Support

Works with clinic administrators to develop standardized processes for patient access and throughput. Collaborates with clinic administrators to achieve effective change management and assure alignment between clinical and access team members. Fosters a culture of collaboration, trust, and excellence across all clinic teams. Works with team members to define values and standards that foster a shared sense of purpose.

1. Hospital-based Outpatient Services Operation Support

Works with revenue cycle leadership and hospital-based and outpatient service managers to develop standardized processes for patient access and throughput. Collaborates with service line managers to achieve effective change management and assures alignment between clinical and access team members. Fosters a culture of collaboration, trust, and excellence across all hospital-based outpatient services. Works with team members to define values and standards that foster a shared sense of purpose.

1. Systems and Technology Coordination

Collaborates with Revenue Cycle to assist in streamlining navigation systems and assuring timely and efficient communication throughout the patient cycle, from scheduling to billing to payment. Works with IT department to evaluate technology on an ongoing basis. Monitors macrotrends in external navigation systems to evaluate opportunities for SJH.

1. Community Engagement

Champions the development of navigation system with internal and external stakeholders. Provides proactive communication to SJH team members and administration on program status. Works with Marketing to help educate the public on changes to access processes and/or navigation resources.

1. Objectives
   • Develop organization-wide system that creates a more efficient and patient-friendly access experience
   • Growth in clinical and diagnostic services
   • Improved patient experience access scores

Job Requirements:

Minimum Education

Required: bachelor's degree in a related field.

Preferred:  master’s degree in nursing, healthcare administration, or business administration.

Minimum Work Experience

Required: At least 5 years of progressive leadership experience in healthcare. At least one year of clinical experience.

Preferred: 5 or more years of management experience in ambulatory clinic settings

 Required Licenses: NA

Functional Demands:

Working Conditions:

Combination of office, exam rooms, and other clinical settings. Routine travel to outlying clinics. Frequent exposure to communicable diseases, bio-hazards, toxic substances, medicinal preparations, and other conditions common to medical clinic setting. Frequent stressful situations. Approximately 50% sitting and 50% standing/ walking. 50% of the workday spent on a computer. Frequent verbal and written communication, frequent interaction with others including in person as well as via phone and/or video conferencing.

Physical Requirements:

Standing, walking, manual dexterity as required for typing/ computer use. Lifting up to 20 lbs. Must be on-site at the SJH campus or other facilities to perform the duties of this role. Occasional teleworking may be permitted with approval of Chief Medical Group Officer. 

Direct Reports: Patient Access Team Members including front desk operation specialists and team leads.

Reports to: Chief Medical Group Officer, dotted line to Director of Revenue Cycle

 Internal and External Contacts: Clinic Staff and providers, physician services administrative team, hospital and medical group leaders and staff, patients, families

Leadership Capabilities:

1. Approachability
   1. Is easy to approach and talk to
   2. Spends the extra effort to put others at ease
   3. Builds rapport well
2. Interpersonal Skills
   1. Relates well to all kinds of people, up, down and sideways, inside and outside the organization
   2. Builds appropriate rapport
   3. Uses diplomacy and tact
3. Process Improvement
   1. Is committed to continuous improvement through empowerment and management by data
   2. Creates a learning environment leading to the most efficient and effective work processes
4. Planning
   1. Accurately scopes out length and difficulty of tasks and projects and sets goals
   2. Breaks down work into the process steps and develops schedules and task/ people assignments
   3. Anticipates and adjusts for problems and roadblocks
5. Industry Acumen
   1. Knows how the healthcare industry works; understands financial models for successfully running a hospital
   2. Pays attention to current and possible future policies, practices, trends, and developments in healthcare and how those could affect the organization
6. Managing Change + Communication
   1. Able to successfully navigate disruptive change with composure
   2. Can lead others through change by communicating effectively the reason and plans for change, helping them to deal with emotional response to change, and overcoming resistance to change

Qualifications