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Quality Specialist, RCM

Job Description

Job ID: 1195559
Employment Status: Full-Time
More Information:

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. BJC serves patients and their families in urban, suburban and rural communities through its 15 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

Revenue Cycle Management (RCM) is the combination of people, processes and technology that will provide BJC patients and families with a seamless, transparent experience through scheduling, authorization, registration, charge capture, billing and collection.  RCM will deliver state-of-the-art integrated workflows and processes enabled by technology to improve all aspects of revenue cycle functions.  This will position BJC with a sustainable advantage and competitive edge in the communities we serve. 


Overview


Role Purpose

The RCM Quality and Training function ensures RCM team members have the standard work, knowledge, skills, feedback, and resources to be successful. Quality drives the training content, and training ensures quality standards are met. The RCM Quality Specialist has revenue cycle subject matter expertise, specifically in patient access and revenue management, along with an inherent ability to analyze and improve individual team member performance gaps as well as broader, systemic quality gaps. Implements and manages department-level elements of RCM’s quality management system. Is responsible for developing resources and facilitating processes for audits of individual team member performance as well as team level quality. Uses analytic reports to identify broader trends in quality gaps; collaborates with appropriate peers and leaders to identify root causes, develops potential mitigation plans, and implements those plans. Develops and updates standard work documentation; ensures updates are communicated to all appropriate team members and is incorporated into training materials.


Responsibilities

  • Partners with leaders to identify metrics at the individual team member level and at the team-level. These metrics will drive data collection strategy, training content, mitigation planning, and changes to workflows and standard work.
  • Develops and continuously improves RCM’s quality management systems, for individual team member performance audits/mitigation plans and team-level quality audits/mitigation plans.
  • In collaboration with training specialists and preceptors, conducts performance audits on team members. Communicates performance and quality gaps with RCM leaders.
  • Accesses individual team member performance reports and quality analytic reports to identify trends in gaps. Collaborates with leaders and training specialists to analyze the root causes of gaps. Works with appropriate leaders to develop and implement mitigation plans. Identifies trends that may require additional training focus, standard work modification, etc.
  • Collaborates with training specialists and department leaders to ensure documented, easily accessible, current, thorough and accurate standard work (such as policies, procedures, and work flows) is in place for each job role. Incorporates standard work into training courses and materials. Builds consistency across departments.

  • Minimum Requirements

     

    Degree

  • Associate's Degree
  •  

    Experience

  • 2-5 years

  •  

    Preferred Requirements and Additional Job Information

     

    Degree

  • Bachelor's Degree
  •  

    Experience

  • 5-10 years
  •  

    Supervisor Experience

  • No Experience

  • Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Memorial Medical Group, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer