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Penn Medicine, University of Pennsylvania Health System · 8 hours ago

Director Operations CPUP

Philadelphia, PA

Full-time

Onsite

Director/Executive

10+ years exp

Penn Medicine is dedicated to providing high-quality patient care and innovative research. The Director of Operations CPUP will plan, evaluate, and manage day-to-day operations for the department while ensuring compliance with regulatory standards and enhancing patient experiences.

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Responsibilities

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 the Department's 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 the 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 goals such as access to care

Participates in population health and health equity goals and achievement

Conceives, designs, and implements clinical operations dashboards 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 access goals, 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 the achievement of operational and financial goals

Assures patient flow through the completion of required check-in and check-out processes

Oversees daily appointment scheduling and on-site patient experience to ensure access to care and 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

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

Managing risk and enhancing quality and safety

Understanding, monitoring, and adhering to regulatory requirements

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

Incorporates Penn Medicine Experience standards

Oversees physician services cost analysis, focused on identifying and managing physician productivity

Facilitates open sharing of practice management and physician productivity data

Develops and provides access to statistically valid benchmarking data

Provides decision support tools and analytic support through the use of CPT data

As one representative of the Department, participates in financial negotiations with third parties, hospitals, and managed care organizations and maintains relationships

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, and fee schedules

Manages insurers’ QA Audits and represents the department with any necessary responses

Monitors work product and provides reimbursement support and A/R performance of CBO

Schedules and oversees education programs for physicians 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

In conjunction with HR, responsible for select positions; this includes job posting, submission of position justification, performance management, and ensuring mandatory education compliance

Strategizes the recruitment, evaluation, training, and talent development of these positions

Administers talent management initiatives for current and future staff

Creates and implements succession plans for all positions

Implements and oversees the following staff functions: recruitment, development, retention

Responsible for practice operations effective and efficient organizational design including innovative care team models

For all University, UPHS, and SOM staff within the department, ensure 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 with regulatory and legislative changes for all third parties

Acts as Department Liaison and oversees routine audit of billing in accordance with established UPHS guidelines

Is responsible for the development, implementation, and maintenance of policies and procedures to ensure efficient processing of information

Oversees chart review process and conducts an ongoing assessment of documentation to insure compliance with regulations and policies

Ensures compliance with HIPAA, record filing practices, and all related policies

Facilitates the development of technology infrastructure and plans 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

Qualification

Healthcare managementStrategic planningRegulatory complianceRevenue cycle managementLEANSSBBCPTICD-9 codingData-driven decision-makingChange managementTalent developmentPatient care processesLeadershipCommunication skills

Required

Bachelor of Arts or Science

10+ years experience, including Direct management experience, minimum 5-7 years

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

Preferred

LEAN or SSBB

Health care management experience preferred, at least 2 years

Master of Arts or Science, MBA or MHA

Benefits

Comprehensive compensation and benefits program

Prepaid tuition assistance program

Company

Penn Medicine, University of Pennsylvania Health System

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Penn Medicine is a world leader in academic medicine, setting the standard for cutting-edge research, compassionate patient care, and the education of future health care professionals.

Founded in 1765

Philadelphia, Pennsylvania, USA

10001+ employees