PRIMARY PURPOSE

Responsible for the enterprise integration of clinical laboratory services with advanced data-driven knowledge systems. The role is responsible for strategically combining laboratory operations clinical workflow, business (inreach, outreach), and financial knowledge (coding, rev cycle, financial performance) to produce actionable insights. The position is responsible for translating how those combinations can drive achievement of laboratory strategic goals by connecting with multiple healthcare service lines, corporate, operational, and information technology leaders. The role will serve as the lab operations and business analyst expert across multiple enterprise disciplines both within and external to the laboratory, including compliance, audit services, quality, billing and coding, regulatory bodies, finance, revenue cycle management, patient financial services and registration, physicians, ACL Patient Service Centers, ACL clinical and anatomic pathology laboratories, ACL business development/outreach growth, and value-based care. This unified approach will create synergies that improve clinical efficiency and financial responsibility, integrate and leverage diverse data sets to optimize operational performance, and generate actionable intelligence to drive lab innovation and enhance patient care.

Major Responsibilities

Evaluates laboratory clinical information, patient records, financial data, quality metrics, payer information, and other relevant data to identify clinical laboratory trends, patterns, and insights to improve workflow, inform business decisions, provide data-driven reports, and improve patient outcomes.    Ensures lab operations collaboration with corporate departments solve complicated compliance, regulatory, and payor-specific requirements/guidelines. Utilizes deep understanding of laboratory billing and coding compliance to support enterprise initiatives. Partners with Corporate Compliance and advises on nuanced, complex laboratory workflow to assess risk and to ensure regulatory compliance for billing reconciliation, test build workflow review, issues related to out of network payers, and audit findings. Collaborate with finance, revenue recognition, performance service departments, and other stakeholders to perform applicable analyses to understand budget variances, net revenue change, labor and productivity changes, maximize reimbursement, and decrease denials. Understand order to claim end to end workflow to support accurate LIS and EMR interface testing, workflow design, and charge testing. Possess a strong laboratory background with understanding of technical test build, test clinical utility, and application of data in clinical context.  Utilize data driven process design to create, optimize and support Clinical Lab 2.0 and value-based care initiatives  Utilize business process management and intelligence to optimize laboratory business development. Leverage combined clinical and financial data to produce actionable health intelligence that informs laboratory practices, improves patient outcomes, and decreases overall cost of care. Participate in engagements including assessments, implementation, educational activities, and collection and dissemination of meaningful data to support lab operations. Support acquisition of external clients including revenue reports, and development and maintenance of business ROI tools. In any laboratory operation scenario and ad hoc, combine data collection, analysis, and implementation scaled to the enterprise to meet performance and goals  A valued collaborator with all service lines, corporate departments, leaders, and internal laboratory teammates.  Designs and directs the work of the team(s). Selects, coaches, and develops team(s). Sets clear expectations to inspire and motivate the team. Manages performance by recognizing achievement, providing feedback, and administering progressive discipline when necessary. May develop and/or recommend operating and capital budgets and controls expenditures within approved budget objectives. Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that people actions, and the actions of employees supervised, comply with the policies, regulations, and laws applicable to the organization's business.

MINIMUM JOB REQUIREMENTS

Education

Bachelor’s Degree in healthcare administration, business, laboratory, or related field

Certification / Registration / License

n/a

Work Experience

Typically requires 5 years of laboratory experience, including leadership experience

Knowledge / Skills / Abilities

Proficiency in clinical laboratory operations, data analysis tools (i.e., SQL, Excel, Power BI) data visualization and reporting, knowledge management, LIS, and EHR

Experience with revenue cycle, billing and coding (i.e., CPT, ICD-10), claims, and reimbursement process

Excellent interpersonal skills and ability to explain technical concepts to non-technical stakeholders

Demonstrated ability to collaborate closely with physicians and all levels of leadership

Demonstrated ability to be self-directed, results-oriented, and have a creative approach to projects

Excellent analytical, technical, strategic planning, communication, critical thinking, and problem-solving abilities

Must be proactive, flexible, organized, thorough, committed, and motivated.

Oversee departmental budget performance

PHYSICAL REQUIREMENTS AND WORKING CONDITIONS

Operates all equipment necessary to perform the job.

Exposed to a normal office environment.

Willingness to travel throughout enterprise as needed.

PREFERRED JOB REQUIREMENTS

Education

Master’s preferred

Certification / Registration / License

Certifications such as billing and coding, project management, business analyst professional, etc. can be advantageous

 

 

 

 

 

 

DISCLAIMER

All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.

This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position.  Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.