Practice Manager - Pediatrics at Massachusetts General Hospital(MGH)

Posted in Other 12 days ago.

Location: Boston, Massachusetts





Job Description:

Receiving general direction from the Nurse Director and the Chief of the Pediatric Hematology and Oncology Division provides practice management oversight for the clinical operation, administrative work, and clinical research activities within the hematology and oncology practice inclusive of the infusion services practice and the phlebotomy service. Provides supervision, back-up, and cross-coverage support for practice operations as required. Works with the Physicians and other clinical staff members to ensure a quality-based, customer-oriented flow of work. Drawing on a broad understanding of Hospital and physician practices and policies, and displaying a high degree of initiative and independent judgment, the incumbent will continually assess and direct a wide range of practice issues. Requires discretion and judgment to organize priorities, complete tasks, and handle confidential patient information. The position involves coordination of responsibilities related to office management, patient care, administrative, and clinical research. The Practice Manager is responsible for performing and coordinating special projects for the Practice and serving as a Practice representative for office-staff related issues.



PRINCIPAL DUTIES AND RESPONSIBILITIES




  • PRACTICE MANAGEMENT RESPONSIBILITIES





  • MANAGES DAY-TO-DAY PRACTICE OPERATIONS




    • Is responsible for the efficiency of the financial aspects of the units' front desk operations: reception and registration functions; phone systems; patient flow; appointment scheduling.

    • Addresses practice access issues with clinicians and support staff. Works with the MGHfC Access Center and other access and customer services teams at MGH and MGB to ensure consistency and quality of access. Responds to and resolves customer complaints.

    • Serves as point person for Practice and phlebotomy lab environmental issues related to repairs, cleaning, directories, signage, security, etc. This includes but is not limited to responsibility for maintaining relationships with buildings and grounds and ensuring the smooth operation of the Yawkey 8 and Yawkey 6 practice operations sites. Enforces fire and safety regulations for the staff, following established protocols, and ensuring compliance with Joint Commission, OSHA, HIPAA and Hospital guidelines.

    • Work with Nurse Director and MGHfC management and staff to establish off-site satellite clinics and then collaboratively manages the operational needs for each respective site, as necessary

    • Works with all practice and phlebotomy staff to support the care and needs of all the patients we serve with emphasis on working to close performance gaps among operations related to supporting diverse patient populations





    BILLING AND SCHEDULING OVERSIGHT




    • Establish and maintain policies and procedures for EPIC scheduling to ensure continued use and integrity of system. Provide a system of communication for physicians and staff to indicate problems related to scheduling.



    • Establish and maintain policies and procedures to ensure that appropriate third party payer referral/authorizations are in place prior to a patient's visit and that all required worker's compensation authorizations are obtained in a timely manner by personnel.

    • Establish and maintain policies and procedures to support physicians in their completion of accurate and timely billing for submission. Track billing submissions through EPIC reporting to monitor the lag.

    • Understand and educate the staff around International patient processing with the International Office.

    • Understanding and educating the staff around Free Care patient processing with the Financial Access Unit.


    Compliance and Education



    • Work with hospital and professional billing offices, compliance office and Nursing Director to educate attending physicians, residents and clinical support staff as needed regarding billing and documentation requirements as appropriate.

    • Work with physicians and nursing personnel to ensure that all inpatient and outpatient services are appropriately documented.

    • Maintain up-to-date knowledge regarding changes in billing, insurance and compliance requirements and amend documentation requirements appropriately.

    • In cooperation with the clinical and support staff, develop and update on a regular basis patient education materials that discuss medical care issues and available support services in collaboration with the MGHfC patient education program manager.

    • To develop and update documents around payment procedures.


    Billing Issue Resolution



    • Review practice EPIC reports to monitor encounter completion, referral completion and other practice operational performance indicators. Resolve these issues regularly and timely.

    • Act as first point of contact for the billing staff to resolve all billing issues


    Tracking & Reporting



    • Review/verify charges posted by hospital and professional billing office staff for accuracy.

    • Monitor billing statistics to ensure that services performed are submitted through EPIC for billing.



    • Work with attorneys' offices with guidance from risk management as appropriate to provide requested information and ensuring payment for these materials.

    • Work with attorneys' offices to track our participation in and payment for legal cases as expert witnesses.



    • Review billing metrics with Practice and Department leadership on a regular basis. Ensure resolution of correctable billing deficiencies.

    • Participate in billing meetings on a regular basis and participate in staff meetings, educational sessions, or other meetings as required.

    • Partner with the billing compliance team to conduct reviews and provide re-education opportunities.




    EXPENSE PROCESSING AND TRACKING



    Oversee purchasing, invoice payment, and employee reimbursement practices in compliance with MGH/MGB policies.


    • Reviews all supporting documentation for accuracy/appropriateness.

    • Monitors through online reporting any outstanding transactions to facilitate closure.



    • Prepares and processes purchase orders as needed; ensures maintenance of an inventory of supplies for general use. Primary contact for all practice purchases.

    • Work with Nursing staff to maintain procedures for ordering medical supplies for the clinic.



    • Coordinates with IS to arrange for hardware/software installation, troubleshooting, system access, etc.; Serves as resource for Practice members for questions related to information systems; Serves as custodian of any Practice-owned software to ensure only authorized use and security




    HUMAN RESOURCE RESPONSIBILITIES




    • Builds and maintains ongoing working relationships with staff, clinical and physician members of the practice to facilitate positive staff morale. Works to support a positive workplace culture that values teamwork, equity, and diversity.

    • Provides direct supervision and coordination to administrative support staff. Hire personnel, oversee training and orientation, enforce corrective action, conduct performance reviews, approve time off requests, interpret Hospital and MGPO policies and ensure adequate coverage for all areas of responsibility.


    Timekeeping and Payroll



    • Manages staff timekeeping in compliance with institutional policies.

    • Maintains up-to-date knowledge regarding timekeeping and pay policies. Works with the Nursing Director to enforce these policies.

    • Works with payroll and Nursing Director to resolve payroll issues as needed.


    Staff Coordination and Oversight



    • Under the direction of the Nursing Director, oversees staffing schedules and makes daily staffing decisions and provides coordination and oversight of staff for the hematology and oncology division and the phlebotomy service to ensure suitable clinical and administrative coverage.

    • Manages processes and staffing for all practice operations.



    New Hire Processing



    • Provides all new hires with access to the systems and practice software and share drives



    • Prepares all professional staff appointment paperwork and visa applications as needed (for physicians, fellows, post-doctoral fellows), including preparing and mailing acceptance letters, appointment packets, and visa applications and retaining appropriate copies of materials sent.

    • Follows-up with applicants, Credentialing Office, Registrar's Office, Corporate International Office, and Payroll as needed to ensure timely completion.



    ADMINISTRATIVE & RESEARCH RESPONSIBILITIES


    • Meets regularly with Chief and Nursing Director to review ongoing projects and practice issues.

    • In collaboration with the practice, MGHfC leadership and the MGHfC communications team prepares Program Marketing Materials and Web site information.

    • Works with Physician staff, Nursing Director and MGHfC staff to perform outreach activities.

    • Works with physician and clinical staff of the program to develop/provide patient education materials to the patients seen by the practices.

    • Assists the Research Administrative team in supporting management of research fund spending and reporting.

    • Works with practice leadership team to identify, establish, and update office policies and procedures.

    • Provide agenda items and conducts monthly staff meetings to ensure dissemination of information and solicit input from all staff members related to policies and procedures, day-to-day operations, etc.

    • Participate in the budgeting process, as requested/required by Nursing Director and MGHfC leadership.

    • Regularly review and disseminate as appropriate statistics on patient volume, patient throughput, billing and other statistics on a routine basis to Administrative/Executive Director.

    • Perform/coordinate special projects as assigned by the Nursing Director, Chief or MGHfC Executive Director.

    • Supports projects and the Division Quality Champion in advancing the quality and safety efforts within the division.

    • Participates in all Ambulatory Management Forums, reviews all updates and implements changes and new practices flow in the practice as needed.


    SUPERVISORY RESPONSIBILITY



    The Practice Manager is expected to hire, train, and supervise office staff; to provide day-to-day coordination of office operations among staff; to ensure suitable telephone and staff coverage; and to monitor other operational issues to ensure the smooth functioning of the office. Supervision includes oversight of patient services coordinators, medical assistants and other practice staff.



    WORK CONDITIONS AND SCHEDULE



    Normal office conditions. 40-hours standard work schedule. Ability to attend occasional meetings outside of typical work hours is required.



    Qualifications

    QUALIFICATIONS





    • Bachelors degree in Business or equivalent; Masters degree desirable.

    • Minimum of 5 to 7 years of directly related experience.

    • Minimum of 2 years prior supervisory experience.




    SKILLS AND ABILITIES REQUIRED





    • Good command of English language, including medical and scientific terminology.

    • Ability to make decisions quickly and independently

    • Excellent interpersonal/communications skills.



    • Knowledge of organization policies procedures and systems and physician practice management practice

    • Knowledge of and dedication to highest customer service standards



    • Skill in providing support, directions and development to staff and delegating.



    • Skill in gathering, analyzing and presenting data.



    • Ability to take initiative and to exercise independent judgement, decision-making and problem-solving expertise.

    • Ability to re-engineer systems and processes



    • In-depth understanding of all pertinent insurance regulations, HCFA documentation requirements, and billing procedures.

    • Knowledge of ICD-9 and CPT coding, and medical billing. Thorough understanding of RBRVS payment methodology.

    • Exceptional computer skills (including operating systems, word processing, database, electronic mail, Internet, and spreadsheets) required.

    • A "can-do", team oriented attitude is essential, as is the ability to work independently and to interact easily with physicians, other managers, and staff throughout the hospital.

    • Effective interpersonal / communication, organizational, and analytical skills, and the flexibility to handle multiple tasks and deadline pressures are critical.






    EEO Statement

    Massachusetts GeneralHospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, wechoose to lead. Applications from protected veterans and individuals withdisabilities are strongly encouraged.
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