Case Manager - Physician Practice jobs in Novi, MI

POSITION DESCRIPTION:

The Practice Manager is responsible for working with the Site Medical Director (SMD) to oversee the clinical and administrative aspects of the practice(s), including practice profitability, revenue goals and CORE metrics. This includes accountability for clinical quality of care, customer satisfaction, staff satisfaction, productivity, revenue enhancement, managed care performance, staff leadership and assuring adequate access for patients.

ESSENTIAL JOB FUNCTIONS:

Leadership Responsibilities – Directs the internal practice operations; creates benchmarks, tracks and reports progress, researches process improvements/efficiencies, recommends and implements changes.

1. Works with the SMD to develop the vision and direction of the practice in alignment with IHA's priorities.
2. Works with practice providers and practice management team to develop, implement, and manage the CORE Work plan.
3. Assures that the highest quality of care is delivered by the practice:
4. Reviews patient care quality data and peer review data and develops action plans as necessary.
5. Reviews practice risk assessment regularly.
6. Monitors continuing medical education of the team.
7. Ensures the patient satisfaction scores related to the office demonstrate continuous improvement.

Management Responsibilities – Manages practice staff - hiring, training, supervising, evaluating, disciplining and terminating.

1. Creates a positive and productive work environment to attract and retain staff, providers and patients.
2. Works closely with the SMD, practice supervisors, and the Division Director, to ensure that IHA employees are of the appropriate number and mix of competencies, skill levels, educational and experiential backgrounds, and other qualifications.
3. Organizes and implements orientation and training programs for all new staff and providers under the guidance of the SMD.
4. Promotes educational opportunities for staff and providers; develops future leadership within the office.
5. Reviews annual staff and provider satisfaction reports with SMD, office leadership, providers and staff; Develops, implements and monitors ongoing improvement plans.
6. Works with staff supervisors, SMD and HR to address personnel issues.
7. Contributes to the evaluation and improvement plans for Physicians/APNs.
8. Coordinates the scheduling of providers.

Compliance Responsibilities - Assures the practice's compliance with federal, state and safety regulations.

1. Ensures that the practice maintains a physician documentation and coding audit program.
2. Accountable, with the SMD, for assuring compliance with patient and staff safety regulations.
3. Supports the SMD and clinical leadership with producing plans for improving quality and patient safety.

Communication Responsibilities – Works respectfully and cooperatively with management, staff, patients, and vendors; handling escalated patient and staff issues as needed.

1. Administers regular provider and staff meetings to gather feedback, ensures appropriate patient access and develops teamwork. Assures that all office staff and providers have support and accurate information about IHA activities and goals.
2. Meets regularly with SMD and Division Director to review progress and problems in the practice.
3. Attends Divisional Operating Team and Practice Manager meetings, and others as required.
4. In conjunction with the SMD, meets regularly with practice providers to review material from Operating Team meetings, financials including provider productivity and budget status report, and to review progress on goals and CORE work plan.

Fiscal Responsibilities - Accountable, along with the SMD, for the financial performance of the practice.

1. Develops and manages practice annual budget.
2. Reviews monthly financial data and develops meaningful tools to assist SMD in the understanding of how the practice is performing.
3. Prepares and responds to monthly budget variance reports.
4. Monitors monthly statistical reports and practice trends and develops actions plans accordingly.
5. Works with the Division Director to develop cost effective staffing models and office operations.

Other Responsibilities –

1. Participate in new business development as appropriate for practice.
2. Implements effective, quality marketing programs.
3. Performs other duties as assigned.

ORGANIZATIONAL EXPECTATIONS:

1. Creates a positive, professional, service-oriented work environment for staff, patients and family members by supporting the IHA CARES mission and core values statement.
2. Must be able to work effectively as a member of the leadership team.
3. Successfully completes IHA's "The Customer" training and adheres to IHA's standard of promptly providing a high level of service and respect to internal or external customers.
4. Maintains knowledge of and complies with IHA standards, policies and procedures, including IHA's Employee Handbook.
5. Maintains complete knowledge of office services and in the use of all relevant office equipment, computer, and manual systems.
6. Maintains strict patient and employee confidentiality in compliance with IHA and HIPAA guidelines.
7. Serves as a role model, by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respect cultural differences.
8. Uses resources efficiently.
9. If applicable, responsible for ongoing professional development – maintains appropriate licensure/certification and continuing education credentials, participates in available learning opportunities.

MEASURED BY:

Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

ESSENTIAL QUALIFICATIONS:

EDUCATION: Bachelor's degree is preferred; Combination of 1-2 year's college coursework and, 5 or more year's relevant work experience will be considered in lieu of a Bachelor's degree; additional experience will be considered if there is no college coursework.

CREDENTIALS/LICENSURE: None

MINIMUM EXPERIENCE: Prior leadership experience in a medical office environment or other relevant professional experience; requires a minimum of 4 years in combination with meeting education requirements. Four years of experience directly supervising non-exempt staff and leadership team is required.

POSITION REQUIREMENTS (ABILITIES & SKILLS):

1. Considerable knowledge of health care functions, including clinical functions, medical billing and coding procedures, reimbursement practices and quality improvement initiatives.
2. Knowledge of the legal and compliance aspects of health information systems and best practices in medical office operations.
3. Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, EMR software, Microsoft Word and Excel, intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job.
4. Excellent communication skills in both written and verbal forms, including proper phone etiquette. Ability to speak before groups of people and resolve conflict in situations where the audience may be less than receptive.
5. Ability to work collaboratively in a team-oriented environment; courteous and friendly demeanor.
6. Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, provides, patients, family members, insurance carriers, vendors and the general public.
7. Ability to cross-train in other areas of practice in order to achieve smooth flow of all operations.
8. Good organizational and time management skills to effectively juggle multiple priorities, time constraints and large volumes of work.
9. Ability to exercise sound judgment and problem-solving skills.
10. Ability to coordinate, direct and supervise the work of others.
11. Ability to analyze and interpret data for appropriate and effective response.
12. Ability to handle IHA staff and organizational information in a confidential manner.
13. Successful completion of IHA competency-based program within introductory and training period.

MINIMUM PHYSICAL EXPECTATIONS:

1. Physical activity that often requires sitting or standing, keyboarding, filing and phone work.
2. Physical activity that often requires extensive time working on a computer.
3. Physical activity that sometimes requires walking, standing, bending, stooping, reaching, and/or twisting.
4. Physical activity that sometimes requires lifting, pushing and/or pulling under 30 lbs.
5. Specific vision abilities required include close vision, depth perception, peripheral vision and the ability to adjust and focus.
6. Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.