Head of Referral & Eligibility, Admission & ER

JOB SUMMARY

Responsible for the supervision, processing, and control of Referral and Eligibility of patients in the ER Registration ADT Department. Responsible for making decisions and solving problems regarding patient issues and concerns which may affect treatment and final invoice. Responsible for the maintenance and operations of the Morgue. Act as a patient advocate by maintaining patient's rights to access, treatment, respect, confidentiality, and privacy for all patient outcomes. Maintain interdepartmental communication related to patient affairs activities. Continuously monitor and supervise the activities of the Department and provide improvement plans for areas that need improvement. Control ineligible patients using inpatient facilities.

MAJOR DUTIES and RESPONSIBILITIES

1. Ensures through his/her actions, either directly or indirectly, that a superior quality of medical treatment, compassion, and understanding is given to every patient served at the NMC Hospitals and Clinics.
2. Plan, schedule, and direct the work of the department's staff to meet the hospital objectives.
3. Recommend criteria for selecting the department's or service's professional staff and choose or recommend individuals who meet those criteria.
4. Participate in the recruitment process in his/her department by updating the departmental staffing plan on an annual basis, reviewing credentials of job applicants, and recommending hiring.
5. Provide orientation and training for all staff on the duties and responsibilities for the department or service to which they are assigned.
6. Establish, implement, and maintain continuing professional development programs.
7. Assure that regular and systematic monitoring and evaluation of the quality and appropriateness of services rendered within the service is carried out through designated quality assurance mechanisms.
8. Responsible for monitoring and maintaining staff performance by developing annual performance evaluations to test the employees' competencies and by suggesting training needs and career objectives for employees in the coming years.
9. Participate in creating the policies and procedures necessary to carry out the mission.
10. Review and update departmental policies and procedures using JCIA & CBAHI standards every three years or when needed.
11. Implement Policies and Procedures as well as Rules and Regulations of the Hospital.
12. Recommend space, medical technology, equipment, staffing, and other resources needed by the department or service and have a process in place to respond to shortages.
13. Hold and chair all departmental meetings (monthly or when needed) or appoint a designee to chair meetings in his absence and document the minutes of the meeting.
14. Ensure performance measurement and improvement of the outcomes of the department.
15. Responsible for the motivation and inspiration of the department staff.
16. Lead the Referral and Eligibility section through direct supervision of staff, outside medical reference, rejected cases, facilitate MEDVAC patient acceptance, MOH referrals to in and out hospitals, acceptance, and facilitate EHALA referrals.
17. Direct supervision of Referral and Eligibility staff about referrals and acceptance processes from different entities/hospitals such as National Guard, OHG, ARAMCO, and Insurance Patients.
18. Arrange acceptance for cash patients after proper cost estimation and deposit.
19. Provide monthly reports regarding referrals and eligibility activities, ER registration, and ADT departments to the Director of Patient Affairs.
20. Supervise, monitor, and control the daily business activities in the ER Registration and Admission office as well as staff performance.
21. Assist the Director of Patient Affairs for administrative activities, MOH rounds, quality and safety rounds, etc.
22. Supervise activities related to the Collection department.
23. Supervise activities of overlapping functions affecting patients like coding, approvals, cost estimation, and admission.
24. Supervise daily ER patient flow, identify issues, find solutions, and report to the Director of Patient Affairs.
25. Participate in performance improvement projects.
26. Act as Morgue In-Charge for daily monitoring, reporting as needed to the Director of Patient Affairs Division.
27. Follow the process of body releasing from the morgue.
28. Facilitate and monitor ambulance conduction.
29. Identify and find solutions for immediate patient complaints.
30. Monitor daily staff cashier transactions and submission to the cashier.
31. Supervise filing of legal documents for future reference.
32. Supervise submission of UCAFs, staff deficiencies, salary deduction issues form finance and company section.
33. Perform other work-related duties as assigned by the Director, Patient Services.

Reporting to:

• Director, Patient Services Division

Supervises:

• ADT, ER patient services team

Qualifications:

Education:

• Bachelor's degree in Management/Administration preferable in hospital/healthcare management.
• Master's degree in hospital/healthcare management is preferred.

Experience:

• Eight (8) years of applicable experience related to the position preferably in a large-scale hospital.

Competencies & Skills:

• Excellent public relation skills, people-oriented, and excellent interpersonal relations skills are a must.
• Excellent customer service skills.
• Excellent management skills.
• Relationship building skills.
• Negotiation and influential skills.
• Problem-solving skills.
• Interpersonal skills.
• Decision-making skills.
• Excellent command of written and spoken English and Arabic.
• Computer literacy (Word, Excel, PowerPoint).