Director, Patient Access Services at Kaiser Permanente in Kahului, HI

Job Summary:

The Director, Patient Access is responsible for providing strategic and operational leadership for patient access services within the healthcare facility. This role encompasses oversight of budgeting, staffing, resource allocation, and the design and implementation of process improvements to ensure efficient and high-quality patient access operations. The Director fosters cross-functional collaboration, drives innovation, champions customer service excellence, and ensures compliance with regulatory, financial, and organizational standards.

Essential Responsibilities:

• Manage budgets, staffing, and resource allocation for patient access services to support both day-to-day operations and strategic initiatives.
• Drive process improvements and lead change management initiatives across patient access workflows.
• Oversee execution and training in researching, handling, and mailing member-financial records, ensuring timely and accurate delivery to requesters such as courts, attorneys, and copy services.
• Supervise quality reviews, audits, and education processes related to verification and validation of insurance coverage, coordination of benefits, and related initiatives.
• Partner with vendors to ensure coverage for underinsured and self-pay patients, resolving delays and promoting innovative coverage programs.
• Develop and implement process improvements for third party, workers compensation, and secondary coverage payments, including negotiation of payment terms and the resolution of escalated cases.
• Coach teams on customer service, application processing, and quality assurance, ensuring adherence to policies and compliance with regulations.
• Collaborate with other departments for government audits, policy reviews, and decision recommendations for medical financial assistance (MFA) cases.
• Develop and oversee cash collection and cost-share processes, ensuring SOX compliance and standardization across the facility.
• Recommend and implement strategies for continuous account monitoring, risk analysis, payment terms, and overpayment management.
• Direct the execution of self check-in services, document procurement, and daily operations for Patient Financial Advisors and Admitting teams.
• Coordinate operational performance improvement initiatives with registration, IT, and other service leaders.
• Champion programs to enhance customer satisfaction and communications around cost estimates and cost-share information.
• Ensure the organizations adherence to processes for financial coverage discovery, cost-share estimation, and accurate patient billing.
• Ensures accurate patient accounts by overseeing the management of inquiries from providers, members, attorneys, and other insurance personnel to answer a wide range of highly complex billing questions and evaluating new systems.
• Manages the denial process by leading a teams highly complex work of performance affecting denials and ensuring effective remediation and taking the teams data analysis and drawing conclusions including risks when making recommendations while also ensuring the teams complete remediation activities.
• Accountable for performance metrics, productivity standards, and system and technology recommendations for continual improvement.
• Oversee regulatory policy guidelines and ensure compliance with all federal, state, and organizational requirements.
• Effectively manage multiple priorities and collaborate across departments to achieve high-quality patient services and organizational objectives.
• Leadership and Talent Development
• Foster developmental opportunities for team members and build collaborative, cross-functional relationships.
• Solicit and act on performance feedback, set goals, and provide open coaching to drive performance improvement.
• Hire, train, and develop talent for growth and succession planning; establish performance management guidelines and expectations.
• Guide teams through organizational change, share best practices, and promote engagement and motivation across all units.
• Delegate tasks and decision-making, encourage innovative problem-solving, and facilitate access to key stakeholders.
• Compliance & Regulatory
• Ensures compliance with all applicable federal, state, and organizational regulations and standards

Basic Qualifications:

Experience

• Minimum of six (6) years of experience in patient access, clinic/hospital operations, healthcare billing and collections, data analytics or relevant experience.
• Minimum three (3) years in a leadership role with direct reports.

Education

• Bachelors degree in healthcare administration, business administration, or related field or four (4) years of experience in a directly related field;
• High School Diploma or General Education Development (GED) required.

License, Certification, Registration

• N/A

Additional Requirements:

• Strong knowledge of healthcare regulations, insurance procedures, and patient registration platforms.
• Exceptional communication, leadership, analytical, and relationship-building skills.
• Proven track record in implementing operational improvements and leading organizational change initiatives.
• Experience in data analytics, merchant services, clinic/hospital operations, banking, or healthcare billing and collections.

Preferred Qualifications:

• Minimum three (3) years in a leadership role in a matrixed organization
• Masters degree preferred.

Click here for Important Additional Job Requirements.

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