Director of Patient Services

Position Summary: The Director of Patient Services Operations provides leadership and strategic oversight of multiple high-impact departments that are critical to patient access, documentation, and reimbursement. This includes Office Visit Benefit Verification, Specialty Injection Authorization, Diagnostic Testing Authorization and Surgical Authorization. The Director manages complex workflows originating from internal teams and external vendors.

This role plays a pivotal part in supporting the revenue cycle, ensuring front-end operations are optimized to reduce denials and support clean claims. The Director also leads annual and monthly budget planning, oversees quarterly injectable purchasing based on CMS reimbursement updates, and manages the digital infrastructure supporting department workflows through Microsoft SharePoint, Forms, and cross-divisional tracking systems.

Qualifications:

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field, and at least seven (7) years of leadership experience in a healthcare setting, including a minimum of two (2) years in a director-level or equivalent role.
• Applicants without a bachelor's degree will be considered if they possess ten (10) or more years of progressively responsible healthcare operations experience, with substantial leadership experience specifically in benefit verification, authorizations, revenue cycle operations, and healthcare workflow management.
• Strong knowledge of revenue cycle management, including benefit verification, authorizations, and commercial insurance carrier reimbursement frameworks.
• Proficiency in EMR/EHR systems and Microsoft 365 tools, including Excel, SharePoint, PowerPoint, and Forms.
• Experience overseeing workflows from third-party vendors and managing injectable drug purchasing.
• Demonstrated success in digital process management, team leadership, and cross-functional collaboration.
  
  

Key Responsibilities:

Operational Oversight

• Lead the following departments:
• Office Visit Benefit Verification
• Specialty Injection Scheduling & Authorization
• Diagnostic Testing Authorization
• Surgical Authorization
• Ensure daily workflows run efficiently and are properly integrated with input from internal teams, clinics, and third-party vendors.
  

Revenue Cycle Alignment

• Align benefit verification and authorization processes with revenue cycle goals to reduce denials and ensure timely reimbursement.
• Collaborate with billing teams to address trends in payer requirements, denials, and claims rework.
• Monitor coverage guidelines and reimbursement updates from CMS and commercial payers.
  
  

Vendor & Third-Party Coordination

• Manage relationships with external partners performing benefit, authorization and record copying services.
• Oversee workflow integration, performance monitoring, and compliance with internal service standards.
  
  

Financial Planning & Injectable Purchasing

• Annual budgeting, yearly/monthly forecasting, and financial performance reporting.
• Analyze departmental spend and adjust operations based on budget-to-actuals.
• Manage quarterly bulk purchasing of high-dollar injectable medications, aligning with CMS-published reimbursement (ASP) rates to optimize financial outcomes.
• Partner with Finance and Pharmacy to ensure compliant procurement and inventory strategies.
  
  

Technology & Information Systems

• Create, maintain, and manage department Microsoft SharePoint sites for file access, resource sharing, and project documentation.
• Design and manage Microsoft Forms and data collection tools for internal use and multi-department workflows.
• Build and maintain tracking sites and dashboards accessible by multiple divisions to support transparency, task tracking, and cross-functional coordination.
• Collaborate with IT and departmental leaders to ensure system access, usability, and data integrity.
  
  

Workflow Optimization

• Analyze and redesign workflows for efficiency, accuracy, and volume scalability.
• Incorporate technology and automation where applicable to reduce delays and redundancies.
• Ensure all workflows support compliance, patient experience, and provider needs.
  
  

Performance Monitoring & Reporting

• Track KPIs weekly
• Conduct monthly audits to ensure performance and compliance standards are met.
• Evaluate vendor metrics, turnaround times, and service quality using internal tracking tools.
  
  

Leadership & Staff Development

• Oversee Managers and Supervisors, including evaluations, coaching, goal tracking, and bonus calculations.
• Maintain full department staffing and lead recruitment, onboarding, and training.
• Foster a collaborative, accountable, and high-performance team culture.
  
  

Policy, Compliance & Quality Assurance

• Create and maintain policies and SOPs across all departments.
• Collaborate with Quality Assurance to respond to and resolve patient/provider escalations.
• Ensure HIPAA and payer compliance across systems and workflows.
  
  

Other Duties

• Workflow Optimization
• Analyze and redesign workflows for efficiency, accuracy, and volume scalability.
• Incorporate technology and automation where applicable to reduce delays and redundancies.
• Ensure all workflows support compliance, patient experience, and provider needs.
  

Performance Monitoring & Reporting

• Track KPIs weekly
• Conduct monthly audits to ensure performance and compliance standards are met.
• Evaluate vendor metrics, turnaround times, and service quality using internal tracking tools.
  
  

Leadership & Staff Development

• Oversee Managers and Supervisors, including evaluations, coaching, goal tracking, and bonus calculations.
• Maintain full department staffing and lead recruitment, onboarding, and training.
• Foster a collaborative, accountable, and high-performance team culture.
  
  

Policy, Compliance & Quality Assurance

• Create and maintain policies and SOPs across all departments.
• Collaborate with Quality Assurance to respond to and resolve patient/provider escalations.
• Ensure HIPAA and payer compliance across systems and workflows.
  
  

Other Duties

• Perform additional responsibilities as assigned by senior leadership.