The Children's Hospital of Philadelphia
Philadelphia, PA, USA
Req ID: 25534
Employment Status: AF - Active - Regular - Full Time
Under the general direction of the program director and program medical director, the program manager is responsible for the development and implementation of systems to support the clinical and administrative functions of the Pediatric Advanced Care Team (PACT).
The program manager collaborates with many disciplines, programs, departments, and organizations within and outside the hospital to ensure high-quality care delivery to patients and families that exceeds standards set by appropriate accreditation bodies.
The Program Manager’s role will manage operations of the program including (but not limited to): personnel supervision; documentation and communication tools and systems; operational budget and financial management; regulatory compliance; quality and performance improvement; project management; program metrics; guidelines, policies, procedures and protocols; payor relationships; philanthropic support; PR/marketing, communications and outreach; education; community relations; and research.
Clinical Operations and Practice Administration:
Be accountable for the development and implementation of operational systems to assure cost effective, patient centered and quality operation of the PACT Program.
Ensure accepted standards of clinical care and quality using NHPCO standards as well as other nationally accepted clinical evidence.
Ensures accountability of staff for maintaining accepted standards of clinical care and quality.
Together with the Medical Director, supervises development of clinical documentation standards, templates in the electronic health record (EHR). Collaborates with Epic team for development and implementation of electronic care plans; patient criteria; and clinical flow sheets that support the needs of this multidisciplinary program.
Establishes clinical protocols, policies and procedures and treatment care plans in conjunction with the clinical team and Medical Director.
Develops and implements interdisciplinary staffing plan.
Manages program space to support clinical productivity; including assurance of appropriate space allocation and use, assessment of current and future space needs, and compliance with Joint Commission and other regulatory guidelines.
Partners with PARC to ensure that the process for scheduling, pre-registration, precertification, and financial counseling is family-focused and easily accessible.
Continuously reviews systems, processes and procedures to enhance quality of care as well as patient and provider satisfaction.
Uses billing, research and scheduling reports to enhance operations and financial performance.
Fosters an environment that is customer service oriented, with “customers” defined as patients, their families, payors, referring physicians, and clinical Care Teams.
Responds to patients, their families and staff regarding issues related to patient care in a timely and helpful manner.
Fosters a climate of survey readiness. Ensures that all clinical program activities are in compliance with Joint Commission, the Department of Health, HIPAA, Patient Safety, departmental and hospital guidelines.
Works with IS (as needed) to purchase and maintain the use of information systems equipment, software, including planning for future needs.
Be responsible for implementing project solutions and support for data analysis and interpretation, including outcomes measurement.
Advocacy, Communications, Outreach & Development:
Collaborates with the Marketing and Public Relations, Internal Communications departments and CHOP Foundation to develop a coordinated approach for all marketing, communications, outreach and development activities related to the PACT Program.
Supervises the development of promotional and educational awareness activities for the PACT Program, targeted to referring physicians, payers and patients/families, including, videos, handouts, brochures and other such material.
Plans, develops and participates in outreach events as it pertains to initiatives and strategies in the community and with managed care payers.
Partners with external organizations to provide community services. Reports activities and community benefit to internal CHOP collaborators, i.e. Government Affairs.
Job Responsibilities (Continued)
Ensures effective resource stewardship, cost control, and revenue enhancement.
Develops operating budget (including collection analysis, revenue projections, and expense analysis) for all programmatic, special purpose and related hospital accounts; monitors and adjusts for monthly variances in revenue or expenses; manages expenses within established limits
Analyzes monthly productivity, revenue and expense reports and takes necessary measures with key stakeholders.
Performs financial analysis related to new program development and implementation.
Collaborate with physician leadership in developing an ongoing needs plan for staffing and workspace expansion.
Identifies opportunities for grant funding including industry support and government funded agencies. Writes and submits grants for funding to support the program.
Projects and analyzes revenue from various sources including: grants, gifts, institutional and departmental funds.
Develops the proposals and analyses that are required for the Hospital’s capital budget process.
Provides strategic financial planning for the long-term sustainability of the program.
Billing and Compliance Oversight:
Identifies opportunities for commercial and government reimbursement for services provided.
Monitors flow of charges and reviews the monthly billing, accounts receivable and rejection reports, and responds to issues identified.
Works with central billing office in updating all program fees; involves an understanding of ICD and CPT codes.
Collaborates with PARC leadership on front-end billing processes (co-pay collection, bill generation, and follow-up, etc.).
Communicates and collaborates regularly with compliance staff to ensure adherence to compliance guidelines, clinical staff education, and complete charge capture.
Collaborates with Managed Care Department to ensure proper reimbursement of services rendered.
Human Resources/Personnel Management:
In conjunction with the Medical Director, coordinates recruitment of qualified and competent faculty, providers and staff.
Responsible for general human resources oversight (including, but not limited to): management of job descriptions
posting, recruiting, advertising, hiring, and onboarding of staff
payroll processing, employee evaluations, and special employee issues.
training, mentoring, staff recognition and team building.
completion of performance evaluations for all assigned staff in a timely manner.
Enforces and assists in the interpretation of CHOP’s Human Resources Policies and Procedures, including employee relations, rules of conduct, disciplinary action, grievance procedures, and other personnel issues.
Education, Research and Professional Activities:
Develops and designs educational programs and materials.
Maintains knowledge in the area of palliative and hospice care. Attends relevant conferences/workshops.
Participates in professional organizations.
Contributes to the expansion of knowledge within the field of Palliative Care.
Participates in the team’s development and implementation of clinical research protocols.
Contribute to the authorship and publication of scientific manuscripts.
Job Responsibilities (Continued)
Required Licenses, Certifications, Registrations
Required Education and Experience
Bachelor’s degree in nursing or healthcare related field required.
Five (5) years of healthcare experience.
Previous experience in health care practice and understanding of operations, registration, customer service, human resource management, finance and medical records management.
Preferred Education, Experience & Cert/Lic
Master’s degree in nursing, healthcare related field, public health, or leadership.
At least three (3) years in a leadership position, preferably in a pediatric healthcare setting.
Practical experience in palliative care, hospice, internal medicine or oncology.