Practice Optimization Partner

Job Summary

Practice Optimization Partners are front end practice operational partners working with clinic operators and leaders to drive performance improvement upstream in the revenue cycle. The Optimization Partners support providers, practice leaders and practice associates in clinic processes to create a smooth intake of information needed for claims to be paid. The team focuses on the work performed in physician practices and centralized scheduling from first phone call thru charge submission/reconciliation. This team works to determine the root cause of issues creating a loss or slowdown of currency expected. Practice Optimization Partners recommend best practice counter measures to improve revenue which could include process improvement, automation and/or efficiencies. The overall purpose of this role is to collaborate with our client to ensure awareness of their role in the revenue cycle and drive issue resolution within client practices. This work leads to an improvement in the clinic’s financial health and in turn…more cash.

Touchpoints

Front Desk Staff Practice Managers/Administrators Directors C-Suite

Breakdown Of Responsibilities

Monitor, Review and Analyze Client Data (to include, but not limited to):

Preparing and reviewing Market, Practice and Provider Scorecards Summarizing Scorecards Reviewing Analytics data Reviewing and analyzing EHR dashboards and data Root Cause Analysis of Data Abnormalities Preparing and reviewing Practice Profiles Work queue Monitoring and Issue Resolution Analyze and Prepare Denial Avoidance Slides Work queue Issue Resolution Front Desk Audits Practice Reviews Preparing Executive Summary Reviewing practice processes following the patient/charge Reviewing for automation opportunities to improve processes

Client Support and feedback (to include, but not limited to):

Necessary at elbow training Revenue Cycle EHR Scheduling and/or Registration Processes Group education to client front desk, managers, directors Work queue issue resolution Office Touches Practice manager meetings Client Relationships Client front end revenue cycle meetings Client practice (front end) issues Information Distribution Practice support Epic Go Live Educational Practice Revenue Cycle Tip Sheets Initiate Best Practice Process Recommendations

Administrative (to Include, But Not Limited To)

Client Correspondence/Emails Weekly Report outs Team Meetings

Personal Development (to Include, But Not Limited To)

1:1’s with manager Course work Educational sessions Training

Other Duties As Assigned

Expectations of this position are as follows:

Practice Level Connecting Point

Leadership

• Able to adjust quickly and seamlessly to abrupt change.
• Able to adapt and create multiple solutions to complex problems
• Able to present information effectively to associates as well as senior leadership.
• Able to adapt and adjust to increased workflows.
• Able to learn and adapt to different technology
• Fluent and proficient in Microsoft Office products
• Must have excellent written as well as verbal communication skills
• Able to quickly learn procedures and processes of new clients or another client assigned to them.
• Ultimately responsible for the KPI’s as well as health of clients at a practice level for all front end KPIs
• Has a consistent presence in the client market to provide:
• Support, review processes, provide feedback and identify areas of opportunity.
• Travel requirements will be:
• Able to travel to a client within 48 hours’ notice.
• Travel up to 80%
• Ensures all administrative and planning functions are still completed even when traveling
• Maintains knowledge of MGMA Revenue Cycle best practices ensuring high productivity and proficiency standards are met
• Promotes a culture of collaboration between the PRC and practices and is considered the face of Ensemble Health Partners physician revenue cycle.
• Demonstrated ability to manage the day-to-day operations of multiple mid to large sized organizations providing a diverse and complex offering of services to the community sometimes in geographically different locations
• Understands and stays abreast of payer requirements and changes in the industry and communicates those changes as well as the financial impact to local and internal PRC leadership
• Review and analyze client metrics and identify trends and issues, Monitors performance KPIs and routine reports
• Identifies and assist projects, determining root cause of issues, providing resolution and stabilization plan, as well as monitoring status post project
• Partners with practice operations and leadership to improve front end revenue cycle metrics affected by clinic workflows, processes and habits, as well as working to establish best practices and efficiencies
• Influences practices leaders to adopt and adhere to MGMA best practices.
• Completes other duties as assigned.
• Follows all SOP’s and policies as defined by Ensemble Health Partners and the Revenue Cycle Liaison team.

Performance Monitoring/Improvement

• Works collaboratively with all PRC departments to understand impact of practice operations and workflows of Revenue Cycle performance
• Has a working knowledge of PRC projects and KPI’s, how they relate to best practice and industry standard benchmarks and the operational changes necessary to ensure top tier performance
• Ensures internal performance improvement plans are developed and implemented when necessary
• Review Work queues and Hold Buckets communicating and influencing responsible parties to clear accounts
• Creates, analyzes and implements processes to improve the quality of front-end revenue cycle operations through key performance/operations indicators
• Identifies process flow or operational structure problems impeding financial outcomes, proposes solutions, and collaborates with department to implement corrective actions
• Utilized root cause analysis to develop deeper understanding of process or operational structure problems
• Analyzes, monitors and communicates financial and operational performance, trends and results to stakeholders
• Performs Revenue Cycle practice assessments working with practice leaders to create action plans to support improvement of Key Performance Indicators
• Attends the Physician Revenue Cycle Denial Avoidance Committee as necessary and ensures action plans are developed and implemented to avoid future first pass denials to the physician group.

Communication

• Builds relationships with client practice leadership, associates, and providers to ensure open communication
• Provides Quarterly practice profile reports which is a deep dive approach to the front-end financial health of a practice and meeting with client practice leadership to communicate client financial health
• Provides practice leaders with a scorecard that contains an overview of their practices front end KPI’s and how that practice is preforming compared to other practices within that specific client.
• Provides updates to client practice leadership regarding ongoing PRC projects and the impact on performance metrics
• Provides timely information to PRC leadership and departments on operational changes, new business developments, and service line expansion that will impact Revenue Cycle
• Communicates in a way that promotes trust and credibility between the PRC and client leadership and strives to strengthen local and corporate relationships for positive outcomes
• Escalates issues to PRC leaders as necessary to ensure timely resolution
• Collaborates with practice management on day-to-day front end revenue cycle operations
• Partners with providers to ensure all charges are captured
• Communicate best practice workflow recommendations to front end associates and leadership
• Initiates, develops and educates providers and staff on current revenue cycle Best Practice standards and initiatives

Innovation

• Demonstrated ability to work independently to ensure Revenue Cycle operations are managed efficiently and effectively
• Ensures that best practice Revenue Cycle processes are communicated and implemented where necessary
• Coordinates with client leadership to discuss both strengths and opportunities for improvement to meet performance metrics
• Expected to consistently identify and make suggestions for process improvements and develops project plans with target milestone dates
• Follows up and ensures action plans are completed in a timely manner. This includes follow up audits to ensure the action plan had the desired result.
• Always looking for automation and efficiencies
• Able to perform in depth analysis to define the root cause of an issue as well as identify efficient and effective solutions
• Able to understand KPI’s and what actions influence the metric.
• Able to make decisions and act with minimal direction while keeping their leader informed
• Must be an independent thinker

Job Competencies

• Valuing Differences – Works effectively with individuals of diverse cultures, interpersonal styles, abilities, motivations, or backgrounds; seeks out and uses unique abilities, insights, and ideas. Considers the collective.
• Collaboration – Works cooperatively within teams and partners with others, both internally and externally as needed, to achieve success; focuses on the results of the team, not the achievements of one person. It’s “All for One and One for All”
• Accountability – Accepts personal responsibility and/or consequences of failure and successes, delivering on commitments and refocusing effort when needed. Someone who is willing to step up and own it.
• Time Management – Effectively manages personal time and resources to ensure that work is completed efficiently.
• Developing Trust – Gains others’ confidence by acting with integrity and following through on commitments; treats others and their ideas with respect and supports them in the face of challenges.
• Takes Initiative – Takes prompt action to accomplish goals and achieve results beyond what is required; is proactive and pursues relentlessly.

Essential Job Functions

Clear understanding of the revenue cycle operations in a physician practice: first phone call thru charge reconciliation.

Ability to perform critical thinking analysis understanding the upstream and downstream connections of front-end physician practice KPIs.

Proficiency in running, manipulating, preparing and presenting front end physician practice data while performing root cause analysis of the originating cause and effects of KPI issues.

Proficiency in preparing and presenting executive level summaries, client presentations and professional level report outs.

Proficiency with technology and ability to learn new EHR platforms and their workflow processes.

Ability to have meaningful, crucial and influential conversations with Ensemble and client leaders, staff and providers while managing relationships.

Independent thinker with the ability to think thru and identify best practice opportunities.

Independent project management and execution while monitoring, tracking and trending the revenue impact.

Ability to hold themselves accountable to front-end performance, which not performing the work themselves.

Ability to solve complex problems and provide documented solutions and recommendations to clients.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Experience Preferred

5-7 years in a physician/healthcare environment

Education Preferred

Bachelor’s degree or Equivalent Experience

Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

Scheduled Weekly Hours

40

Work Shift

Days (United States of America)

We’ll Also Reward Your Hard Work With

• Great health, dental and vision plans
• Prescription drug coverage
• Flexible spending accounts
• Life insurance w/AD&D
• Paid time off
• Tuition reimbursement
• And a lot more

Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact our Human Resources Department at 877-692-7780 or [email protected]. This department will make sure you get connected to a Human Resources representative that can assist you.

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