Hospital Director Patient Access

Overview

• Lead patient access and utilization management functions at a healthcare organization, ensuring seamless operations and optimal revenue cycle performance.
• Oversee registration, financial clearance, insurance verification, and utilization review programs to enhance patient flow and satisfaction.
• Drive compliance with state, federal, and accreditation standards while implementing strategic initiatives to improve processes.
• Collaborate with hospital-wide teams to achieve operational excellence and enhance patient care delivery.
• Develop and lead the Utilization Review Committee, ensuring consistent physician participation and compliance.
• Provide strategic oversight for billing, coding compliance, and enterprise risk management initiatives.
• Analyze departmental performance trends to support forecasting and strategic planning efforts.
• Design and deliver compliance training for staff, medical providers, and board members.

Key Responsibilities & Duties

• Plan, organize, and direct operations of Patient Access and Utilization Management functions.
• Oversee scheduling, registration, insurance verification, financial counseling, and admissions processes.
• Ensure accurate patient status identification and optimal revenue cycle outcomes.
• Develop inventory and cost accounting policies and reporting mechanisms.
• Identify and resolve quality and risk issues while ensuring regulatory compliance.
• Lead comprehensive auditing and monitoring programs to mitigate compliance risks.
• Manage confidential reporting systems and investigate compliance concerns effectively.
• Collaborate with executive leadership on strategic initiatives and performance improvements.

Job Requirements

• Bachelor’s degree in Nursing, Business Administration, Healthcare Administration, or related field; Master’s degree preferred.
• Minimum 10 years of progressive administrative and supervisory experience in healthcare management.
• Proven ability to manage multiple projects with strong budgeting and negotiation skills.
• Functional knowledge of computers, spreadsheets, and hospital information systems.
• Thorough knowledge of patient access, utilization management, and medical terminology.
• Detailed understanding of Joint Commission, NCQA, CMS, and state regulations.
• Strong verbal and written communication skills with collaborative abilities.
• Experience in insurance verification, coverage interpretation, and revenue cycle optimization.