Director of Financial Clearance

GENERAL SUMMARY:

The Director of Financial Clearance is responsible for the effective functioning of pre-service insurance and patient financial clearance processes across a multi-facility integrated healthcare delivery system. This includes insurance verification and patient financial counseling functions associated with emergency, inpatient, and outpatient services performed by Henry Ford Health System hospitals and facilities.

The Director of Financial Clearance identifies and executes strategic initiatives to achieve revenue cycle goals of improved yield, reduced cost, and outstanding patient experience, with a particular emphasis on innovation in technology and automation. The successful candidate is highly skilled in managing a high-volume production operation, effective technology and process design, project execution, critical thinking, and creating an outstanding employee and patient experience.

PRINCIPAL DUTIES & RESPONSIBILITIES:

• Leads team of 70+ employees responsible for pre-service insurance and patient financial clearance functions across a multi-facility integrated health system; functions include pre-registration, coverage validation, benefit verification, self-pay screening, Medicaid application assistance, and patient financial counseling
• Leads hybrid team consisting of remote workers and on-site patient facing financial counselors across 13 acute care hospital sites in southeast Michigan; accountable for successfully leading team through change and adoption of new technologies, processes, and performance standards
• Builds and implements effective work processes, work queue structures, quality assurance processes, and associated technology to effectively manage a high-volume production operation
• Works closely with operational partners to implement best practice front end workflows, including implementing internal and patient facing automation to achieve a "touchless" front end experience
• Leads strategic Revenue Cycle Playbook initiatives to improve yield and reduce cost: achieves targeted cost savings, collaborates closely with system patient access, operational, and CBO teams to achieve top quartile performance in registration accuracy, front end denials, and front end preventable loss write offs
• Implements innovative solutions and best practices in the pre-service patient financial journey to promote transparency, engagement, and outstanding patient experience in service of HFHS' mission
• Manages multiple vendor relationships, including the health system's Medicaid enrollment vendor, utilizing structured mechanisms for evaluation and account placement to achieve optimal ROI
• Leads development of reporting, metrics, and data analytics to support daily operations/production management, internal customer needs, and ongoing program evaluation against national benchmarks
• Recruits and develops leaders to build a culture of high performance and engaged workforce
• Collaborates with Central Business Office to support managing and resolving coverage related insurance denials and recovery efforts
• Prepares annual budget and manages expenses and staffing levels
• Oversees/directs the development of policies and procedures for the department
• Demonstrates belief in the mission of Henry Ford Health System through the ability to articulate, interpret, and incorporate its mission into departmental goals and objectives
• Supports the standards set forth in the HFHS Code of Conduct by creating an atmosphere of commitment to legal and ethical standards
• Performs other related duties as assigned