Director, Care Connections Access

University Hospitals•Shaker Heights, OH

About The Position

The Director of Care Connections Access is a senior leader responsible for patient access operations across a designated market, including registration, scheduling, authorization, financial clearance, and point-of-service collections. The Director oversees leaders and staff, ensures accountability and productivity, manages hiring and performance, and leads retention and engagement efforts. This position provides 24/7 on-call support to department leaders and processes payroll and time-off requests for direct reports. The Director leads efforts to reduce bad debt and denials and increase cash flow. They oversee patient estimates, financial education, payment plans, and pre- and point-of-service collections, and monitor unbilled accounts and related trends. They partner with hospital leaders across the market to advance shared goals and own eligibility, authorization, and collection processes at designated facilities or service lines. The role ensures successful point-of-service scheduling in the Emergency Department and compliance with IMM, MOON, and MSPQ requirements. It oversees medical-necessity verification, patient education about covered and non-covered services, and authorization workflows. The Director also manages and improves Revenue Cycle Access functions, including eligibility, authorizations, collections, denial management, account resolution, quality measures, registration, and patient experience. The Director analyzes workflows, outcomes, and trends; leads process-improvement initiatives; reports and dashboards on key performance indicators; and supports IT system evaluation, testing, and upgrades. The role manages departmental budgets, contracts, vendor relationships, policies, training, and regulatory compliance; safeguards Protected Health Information; and leads or supports Patient Access audits. The position requires dependability in a 24/7/365 department, travel to other enterprise sites, and possible overtime.

Requirements

Bachelor's degree required.
At least 7 years of progressive experience in healthcare revenue cycle operations required.
At least 2 years of supervisory experience, including hiring, training, evaluating, disciplining, developing, and engaging staff members, required.
Experience in an academic medical center and/or multi-system hospital required.
Experience using multiple complex software solutions required.
Ability to develop and implement new systems and procedures.
Knowledge of compliant front-end processes, including regulatory and payer requirements.
Dependability in a 24/7/365 department and willingness to travel to other enterprise sites, including possible overtime.
Strong analytical skills.
Ability to perform in a fast-paced, stressful environment, such as an Emergency Department.
Ability to work independently and as part of a team in a fast-paced environment.
Strong written and verbal communication skills and a professional demeanor.
Detail-oriented and organized, with analytical and problem-solving ability.
Ability to use PCs, Microsoft Office, and general office equipment, including printers, copy machines, multi-line phones, and fax machines.

Responsibilities

Ensure direct reports follow the Leadership Rhythm of Accountability, including meeting cadence, reporting, and follow-through on action items.
Oversee leaders and staff and ensure department productivity standards are met or exceeded.
Hire, coach, and evaluate personnel, including conducting routine performance reviews and addressing compliance with policies and procedures.
Lead team retention, engagement, and positive-work-environment efforts.
Provide 24/7 on-call support to department leaders to help maintain staffing levels.
Process payroll and approve time-off requests for direct reports.
Lead initiatives to reduce bad debt and denials and increase organizational cash flow.
Oversee patient estimates, education about charges and out-of-pocket liability, payment plans, and pre- and point-of-service collection practices.
Monitor unbilled trends and daily unbilled accounts, identify lasting process, people, or technology solutions, and ensure timely disposition.
Support staff in meeting daily cash collection, authorization, and eligibility goals and hold staff accountable for collection performance.
Provide regular updates to hospital leaders in the designated market and collaborate with facility leadership on Patient Access outcomes.
Own eligibility, authorization, and pre- and point-of-service collection processes at designated facilities or service lines.
Ensure successful point-of-service scheduling in the Emergency Department.
Ensure compliance with IMM, MOON, and MSPQ requirements and oversee medical-necessity verification and patient education regarding covered and non-covered services.
Oversee authorization workflows, payer requirements, escalations, monitoring, and productivity to ensure authorization is obtained before services are provided.
Manage Revenue Cycle Access functions, including eligibility, authorizations, medical necessity, collections, denial management, account resolution, quality measures, and related initiatives.
Oversee patient interviews and use of complex applications to create or validate patient medical records and insurance or billing claims.
Ensure accurate insurance coverage, benefits, plan allocation, eligibility verification, and appropriate action for non-covered or out-of-network services.
Ensure registration quality across direct and indirect areas and lead initiatives affecting registration and pre-registration.
Analyze department workflows, outcomes, and trends; identify continuous improvements and modernize pre-registration and registration processes.
Plan and execute Revenue Cycle Management and process-improvement initiatives; analyze and report access and revenue-cycle metrics.
Work with Finance, Payers, and Managed Care on eligibility strategy and pre-authorization determination denials.
Lead workflow efforts in assigned areas, adjusting work assignments to meet operational needs.
Use electronic reports, worklists, and queues to identify claims needing updates and make corrections for accurate, timely billing.
Ensure staff have the tools, system access, and training needed to meet individual and departmental performance and patient-experience measures.
Create reports and dashboards to measure key performance indicators.
Assist with IT system evaluation, testing, and reporting related to upgrades, code changes, and process improvements, in collaboration with IT, system owners, and vendors.
Create and monitor departmental budgets, regulatory compliance, contracts, and vendor relationships; write policies and standard operating procedures and ensure staff understand and follow them.
Ensure staff complete required education and comply with departmental and enterprise requirements, including emergency management procedures for staff and patient tracking and safety.
Maintain confidentiality and safeguard Protected Health Information in accordance with regulations and organizational policies.
Lead or own internal and external audits related to Patient Access, or support audits where Patient Access is a stakeholder.
Travel to other enterprise sites and locations as required, and perform possible overtime.
Perform other duties as assigned and comply with organizational policies and standards.