Business Practice Manager - University of Maryland Medical System

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General Summary

Under general administrative direction, the Business Practice Manager is a member of the operations team and manages the business activities of one large or multiple clinical practices. Responsibilities include management of registration, scheduling, revenue cycle management, budget management in partnership with Nurse Manager, special projects, reviewing and evaluating departmental activities, overall financial performance and compliance.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. In partnership with the Nurse Manager, supervises center Practice Coordinators/Administrative Support Staff and assures proper resource levels at all centers. The Business Practice Manager is responsible for one or more departments.

1. 1. 1. Provides input for the development of budget and financial goals.  Gathers data and writes justifications for personnel, capital expenditures for equipment and supplies.
      2. Controls utilization of fiscal resources.  Evaluates, identifies and makes recommendations for improving cost-effective delivery of care
      3. Works with the Nurse Manager to interview, hire, train/orient, supervise work performance, assigns work and work schedules.
      4. Establishes clear and concise expectations, organizes assignments, reviews work, assesses performance, administers competencies and provides constructive feedback. 
      5. Evaluates and identifies staff development needs and plans and implements training based on those needs.
      6. Ensures the accurate and timely communication to staff with respect to changes in the registration, scheduling, referral and charge reconciliation process.  Includes insurance and payer updates, downtime registration and system upgrades.  
      7. Counsels and disciplines staff and recommend personnel actions in accordance with UMMC HR and departmental policies and procedures. 
      8. Completes annual administrative staff performance evaluations in a timely manner for non-clinical staff. 
      9. Demonstrates and promotes positive employee relations; supports staff education and development.
      10. Creates action plans to ensure budget variances are appropriately identified and corrected.

2. Monitors and audits the efficiency of patient registration, scheduling and referrals/authorizations ensures all aspects of these administrative components are accurate and complete. 

1. 1. 1. Completes and submits all relative finding/trends to department managers and at staff meetings.
2. 1. 1. Assigns tasks to ensure the workload is evenly distributed and patients are registered in a timely manner.
      2. Managing accuracy of provider scheduling templates and/or coordinate with proper schedule owner. Including design, master and daily adjustments, corrections and new provider and visit type setup and maintenance.
      3. Oversee staff efforts in collecting accurate and timely registration and encounter information.
      4. Assures that all appropriate work queues are actively reconciled and current.
      5. Monitors performance with prior authorizations and trends center denials.  Develops strategies to mitigate.
      6. Identifies staff needs for in-services, training and remediation. Assigns, coaches and mentors appropriately.

3. Supports achievement of center’s respective operating budget performance targets, which include goals for patient panels, patient visits, and revenue and expense targets.

1. 1. 1. In conjunction with nurse manager, monitors and assures monthly financial performance to budget and performs variance reporting.
      2. Compiles, analyzes and/or verifies complex financial and/or statistical data and reports as requested; investigates and resolves issues.  Projects and prepares budget recommendations, identifies and resolves anomalies. Works with management team on capacity/space planning and business development issues.
      3. Assures that all Charge Masters are accurate and current.
      4. Responsible for Daily Charge Reconciliation and Charge Error Queues as assigned.
      5. Responsible for Point of Service Collections, including reconciliation, posting and depositing as applicable.
      6. Assists with administrative function for the outpatient practice; accounts payable, billing and/or office expenditures. 

4. Maintain, oversee, evaluate and enhance the efficient organization and operation of the administrative & business processes in the Centers, staff and their related duties, including assuring that all Centers are compliant with organizational and Ambulatory Service business policies and procedures, as well as all relevant state and federal guidelines and other regulatory requirements.

1. 1. 1. Ensures the overall satisfactory financial performance of the department and participates in establishment of clear and concise work procedures and expectations.  Uses a systematic process to complete work-related activity, monitors results and provides positive and constructive feedback to management staff.
      2. Ensures efficient use of paper and electronic filing systems, and that files are updated and accurate.  Orders and maintains office and/or clinical supplies and equipment.  Assists in the care and maintenance of department office equipment.
2. 1. 1. Oversees administrative supply levels and ordering; collaborates with nurse manager regarding clinical supply orders.  Creates service agreements annually to support the department’s needs. 
      2. Carries out duties of Practice Coordinators/Administrative Support Staff as required.

5. Supports the financial aspects of center operations with the Nurse Manager and Directors. Liaisons with Patient Financial Services and RRAS regarding patient billing issues, CDM management and charge capture.

1. 1. 1. Works on problem solving and displays critical thinking to resolve denial mitigation.
      2. Assists with budget and financial variances under the guidance of leadership.
      3. Maintains current charge-master with PFS and ensures all charges in epic departments/centers are active and linked.
      4. Assists in problem solving epic informatics related matters.
      5. Assists with charge audit justifications and business proposals for the development of new charges.
      6. Evaluates, identifies and makes recommendations for improving cost-effective delivery of care. Controls utilization of fiscal resources at the front desk
      7. Assists with equipment requirements for departments; researches and makes recommendations on purchases.
      8. Along with Business Directors, interfaces with Revenue Cycle Team for billing and collections agency and oversees charging, coding and fee tickets/department/practice and plan for continued improvement in operating and financial performance.
      9. Tracks metrics on centers performance per established goals.
      10. Ensures complete and accurate claims and claim related information.
      11. Assists with evaluating any questions related to charge disputes.
      12. Works collaboratively with the leadership to ensure budget and financial goals are met. Creates action plans to ensure budget variances are appropriately identified and corrected. 
      13. Maintains, evaluates and adjusts any issue with zero balance and weekly performance reports. Uses problem solving and critical thinking to access, evaluate, and correct any operational and charge related matters.
      14. Assists with regulated and non-regulated billing, as applicable, for the center.

6. In combined effort with the Nurse Manager acts as network operations liaison with lead providers, Ambulatory Services senior management, Hospital and FPI departments and other related parties as needed.

7. Assure accurate and timely reporting of network activities.

8. Drafts and revises office procedure manuals and ensuring alignment with Ambulatory Business practices, organizational and system policies and procedures.

9. Monitors adherence to policies regarding patient privacy and confidentiality.

10. Intervenes in guest relations as needed.  Determines urgency of situation and calms parents/patients/employees as necessary.  Decides in coordination with the Nurse Manager the need to interrupt, contact physicians, administrator or clinicians; prioritizes patient/customer problems/issues. 

11. Carries out other administrative tasks as required; organizes departmental orientation, annual certifications events and evaluates outcomes, assists with coordination of office moves.  

Patient Safety

Ensures patient safety in the performance of job functions and through participation in hospital, department or unit patient safety initiatives.

1. Takes action to correct observed risks to patient safety.
2. Reports adverse events and near misses to appropriate Nurse Manager or other management authority.
3. Identifies possible risks in processes, procedures, devices and communicates the same to the Nurse Manager for implementation of changes.

Education and Experience

1. Master’s degree in Business Administration, Health Care Administration, Finance, Accounting, or a related field or equivalent required. Equivalent combination of degree in process and experience may be considered.
2. One-year experience in an ambulatory practice setting.  Experience in health care administration, financial analysis, budgeting, reimbursement, accounting, auditing or the educational equivalent preferred.
3. Experience supervising, monitoring daily work activities, evaluating, training and motivating the performance of subordinate technical, operational and/or clerical support staff.

Knowledge, Skills and Abilities

1. Detailed knowledge of physician practice management computer software applications.
2. Excellent organizational skills, ability to prioritize own work and that of others.
3. Highly effective communication, written and organization skills are required. 
4. Detailed knowledge of payers to include, the Maryland Medicaid program, HMO contract requirements, NCQA CMS and The Joint Commission standards.
5. Effective use of Microsoft applications.

All your information will be kept confidential according to EEO guidelines.

Compensation

• Pay Range: $39.42-$48.18
• Other Compensation (if applicable): n/a
• Review the 2024-2025 UMMS Benefits Guide