Employment Opportunities

General Description

Group Practice Managers (GPMs) work within medical practices or groups to develop business strategies, manage budgets, and oversee day-to-day operations (scheduling, billing, collections, etc.). They ensure that the business needs of the practice are met and actively work to recruit new patients. These professionals are in charge of making sure the practice is running smoothly and successfully while also working to expand the business. Since healthcare facilities operate during expanded hours, GPMs may work long hours or be on call regularly. Whether it's a small or large practice, the primary duties of a physician practice manager are to plan, coordinate, direct, and supervise various elements of a medical facility. They may oversee billing and collections, design patient services, or implement work policies for employees. Managers typically have daily interactions with employees and patients. The GPM at the AST Health System will provide continuity of patient care with integrative care with partnering with the Patient Care Teams and Case Managers.  The Health System’s GPM will work with both specialty clinic and primary care clinic and other clinical and service departments in order to effectively manage the patient experience. GPM will handle scheduling, technical issues, and daily patient flow as well as ensure that the day-to-day business is handled according to office and medical guidelines. Other duties will include health information technology interfacing, clinical practice improvement, medical sciences, and medical ethics.  GPMs will also leverage social worker and patient benefit advisors programs to ensure appropriate services and coverages are available to patients requiring services of the health system. Critical synergetic leadership with the business office, patient registration, electronic health records, patient advocate, HIM, medical and clinical services directors, patient benefit advisors, purchased referred care (PRC) are amongst the most active relationships that most foster a sense of teamwork to accomplish the goals of patient care throughout the patient flow throughput of the health system.

Responsibilities

• The GPMs leadership and analytical skills are very important as is the ability to use a computer and knowledge of various software programs. The GPM also acts as a liaison between the clinical and operational leadership.
• The ability to work as part of a team and strong communication skills are often requirements of the job. Due to the complexity of clinical and non-clinical operations, managers may be called upon to evaluate standards of care for patients.
• Completes capture of patient revenue in every area that generates charges, management in relation to charging mechanisms and triggers, ensuring clean handoffs between clinical departments, strategic pricing, denials management, billing management and clinical operations relations with the business office.
• Assists in the resolution of problems causing payer denial or failed Medicare edits as they involve the charge master and professional billing office.
• Works collaboratively with the revenue producing department staff, physicians, and administration to ensure all charges are being captured and documented.
• Fosters partnering relationships with the Compliance Office, Patient Financial Services, Professional Billing Office, Health Information Management department, and other third parties to ensure the accuracy of the Charge Description Master (CDM) and fee schedules.
• Coordinates with Finance/Business Office, Health Information Management (HIM) and other coding professionals to ensure that the codes contained in the CDM and professional fee schedule are accurate and in compliance with regulatory and/or contractual guidelines and that claims logic is appropriate for accurate billing.
• Ensures the on-going accuracy and integrity of the CDM and professional fee schedule by ensuring that all charges are communicated and coordinated with the performing departments and physicians to implement necessary changes to charge documents, charge capture process, and order entry procedures.
• Facilitates positive communication and builds strong relationships between Professional Revenue Cycle Management Operations, clinic staff, and payors regarding revenue cycle matters.
• Establishes performance goals and expectations relevant to the professional revenue cycle.
• Prepares annual objectives, plan of action and budgets, as appropriate. Monitors benchmark data related to revenue cycle performance.
• Plans and schedules annual audit of selected clinical departments; compares medical records against claim to ensure optimum and appropriate charge capture and coding accuracy.
• Performs Gap Analysis of all the Revenue Cycle departments and makes recommendations for process improvements and training to the Compliance Officer, Finance Officer, and/or Deputy Director.
• Designs, analyzes, and implements information and reporting systems to monitor, detect and correct variations in revenue cycle performance.
• Works collaboratively with registration, patient safety and quality officer, patient advocate, PRC, Administration, to accomplish overarching patient experience satisfaction of patients and their services.

Education, Qualifications & Requirements

• Bachelor’s degree in healthcare management or administration, or a business related field; Masters preferred, also in the same subject area.
• Must have a working knowledge of reimbursement regulations for Medicare, Medicaid and Managed Care and Accountable Care Organizations.
• Must know how to perform proper revenue and reimbursement capture.
• Must be highly analytical, detailed, and independent.
• Proven communication, organizational, and leadership skills required. 
• Other education and experience substituted for above requirements require approval by Executive Director.

• Competent in Health Informatics Body of Knowledge and Practice.
• Liaisons with Security Officer of Health Information and assures compliance with HIPAA and Privacy Act is operationalized within the health system’s compliance program.
• Knowledge of principles and practices of organization, administration, fiscal and personnel management.
• Knowledge of local, state and federal regulatory requirement related to the functional area.
• Ability to conduct and interpret qualitative and quantitative analysis, financial analysis, healthcare economics and business processes, information systems, organizational development, health care delivery systems, project management or new business development.

• Ability to manage, organize, prioritize, multi-task and adapt to changing priorities.
• Ability to provide leadership and influence others.
• Ability to foster effective working relationships and build consensus.
• Ability to mediate and resolve complex problems and issues.
• Ability to develop long-range business plans and strategy supporting the ASTHS Strategic Plan.
• Must have Oklahoma Driver’s License.
• Must be CPR/BLS Certified and current.
• Other duties as assigned by supervisor or Executive Director.

• Must be able to lift, push, pull and carry up to fifty (50) pounds.
• This position will require lifting, pushing, pulling and carrying more than 20 pounds up to 70% of the time.
• This position will require lifting, pushing, pulling and carrying more than 30 pounds up to 25% of the time.

• This position will have constant contact with employees, patients, families and visitors.  The GPM will work with other healthcare facilities and offices as needed.  This positon will travel in all weather conditions, there is potential for exposures to infectious diseases including AIDS, Hepatitis B, and COVID19 viruses.