Director of Central Authorization - Detroit, MI
The Director of Central Authorization is responsible for the effective functioning of the central authorization processes within the Corporate Business Office across the multi-facility integrated healthcare delivery system. Central authorization includes the procurement and verification functions associated with all outpatient services and scheduled inpatient surgeries performed by Henry Ford Health System hospitals and employed physician practices.
This position leads through sharing knowledge, motivation and empowerment of the central authorization teams to provide high quality services, which meet or exceed customer expectations. Through collaboration with members of the team and revenue cycle leadership, identifies departmental and business unit priorities, establishes goals and implements strategies designed to foster a culture of innovation, employee engagement, patient satisfaction, and exceptional business performance.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Leads team of 100+ employees responsible for the procurement and pre-service verification of insurance authorizations for those outpatient services performed at HFHS facilities and employed physician practices
- Responsible for the securing of insurance authorizations required for community physicians to perform services at HFHS facilities
- Collaborates with Central Business Office to support managing and resolving authorization-related insurance denials and recovery efforts
- Works cross-functionally with Corporate Revenue Cycle, clinical areas, physician leadership, and business unit leaders on denial prevention and management tactics
- Leads strategic initiatives to improve authorization performance and reduce cost, including implementing end-to-end automation solutions
- Manages multiple vendor relationships utilizing structured mechanisms for evaluation and replacement
- Maintains revenue cycle accountability to the business units
- Prepares annual budget and manages expenses and staffing levels
- Partners with key leaders across the system to enhance the patient experience
- Recruits and develops leaders, to build a culture for high performance and engaged workforce
- Responsible for the continued integration and management of consistent processes, policies, and technology
- Oversees/directs the development of policies and procedures for the department
- Participates in data collection for performance measures, investigates opportunities and implements solutions for optimization
- Demonstrates belief in the mission of Henry Ford Health System through the ability to articulate, interpret, and incorporate its mission into departmental goals and objectives
- Supports the standards set forth in the HFHS Code of Conduct by creating an atmosphere of commitment to legal and ethical standards
- Establishes priorities and long and short-term strategic goals of the department with the assistance of the management team; ensures staff is aligned with the goals and objectives related to Revenue Cycle for the organization
- Actively participates in various committees such as, Revenue Cycle Council, Compliance, etc.
- May develop and/or lead committees/teams related to regulatory changes, performance improvement and compliance
- Ensures that information systems support current and future needs of the department; works closely with information technology in transition planning including, but not limited to, testing, installation and education of staff to produce and maintain high quality data integrity
- Performs other related duties as assigned
- Responsible for maintaining regulatory compliance with external agencies and state and federal regulations; ensures staff is kept informed and educated on process and regulatory changes
- Works with risk management, legal counsel, compliance office, administrative staff, key departments, providers and committees to ensure that the organization maintains appropriate compliance including privacy, security and confidentiality policies, procedures, forms, coding, information notices, and materials which reflect current organizational practices and regulatory requirements
- Is the guiding force behind the identification, establishment and maintenance of quality improvement activities related to central authorization function; promotes the principles of quality improvement and utilizes the results of quality improvement activities to identify areas where change would benefit the team and its customers
- Works with appropriate System and revenue cycle leadership, ensures central authorization representation and participation in appropriate external collaboration, think tanks, benchmarking groups, best practices, other initiatives at the local, state, and national level.
- Bachelor's degree.
- Master's degree in a business or a health administration related field, preferred.
- Five years (5) management experience required with director level, preferred.
- Knowledge of best practices related to revenue cycle operations.
- Experience at a large, complex, integrated healthcare organization, preferred.
- Experience with patient billing, patient accounting systems and other related applications, preferred.
- Experience with clinical operations, preferred.
- Communication skills and the ability to interact effectively with staff.
- Ability to manage, coordinate, and lead simultaneously. Ability to estimate time frames and meet projected deadlines.
- Ability to work with a variety of individuals in executive, managerial and staff level positions.
- Ability to work independently.
- Ability to understand and lead change.
- Goal oriented, exceptional interpersonal skills, change management and political skill.
Must meet or exceed core customer service responsibilities, standards and behaviors as outlined in the HFHS' Customer Service Policy and summarized below:
- Communication Ownership
- Understanding Motivation
- Sensitivity Excellence
- Teamwork Respect
- Must practice the customer skills as provided through on-going training and in-services.
Must possess the following personal qualities:
- Be self-directed
- Be flexible and committed to the team concept
- Demonstrate teamwork, initiative and willingness to learn
- Be open to new learning experiences
- Accepts and respects diversity without judgment
- Demonstrates customer service values
PHYSICAL DEMANDS/WORKING CONDITIONS
- Normal office environment with minimal exposure to noise, dust, or extreme temperatures. Stressful, fast-paced environment which may require travel between business units.
Equal Employment Opportunity/Affirmative Action Employer