Whether the title is manager, medical practice manager, physician practice manager, administrator, practice administrator, executive director, office manager, CEO, COO, director, division manager, department manager, or any combination thereof, with some exceptions, people who manage physician practices do some combination of the responsibilities listed here or manage people who do.
Human Resources: Hire, fire, counsel, discipline, evaluate, train, orient, coach, mentor and schedule staff. Shop, negotiate and administer benefits. Develop, maintain and administer personnel policies, wellness programs, pay scales, and job descriptions. Resolve conflicts. Maintain personnel files. Document Worker’s Compensation injuries. Address unemployment inquiries. Acknowledge joyful events and sorrowful events in the practice and the lives of employees. Stay late to listen to someone who needs to talk.
Facilities and Machines: Shop for, negotiate, recommend, and maintain buildings or suites, telephones, hand-held dictation devices, copiers, computers, pagers, furniture, scanners, postage machines, specimen refrigerators, injection refrigerators, patient refreshment refrigerators, staff lunch refrigerators, medical equipment, printers, coffee machines, alarm systems, signage and cell phones.
Ordering and Expense Management: Shop for, negotiate and recommend suppliers for medical consumables, office supplies, kitchen supplies, magazines, printed forms, business insurance, and malpractice insurance as well as services such as transcription, x-ray reads/over-reads, consultants, CPAs, lawyers, lawn and snow service, benefit administrators, answering service, water service, courier service, plant service, housekeeping, aquarium service, linen service, bio-hazardous waste removal, shredding service, off-site storage and caterers.
Legal: Comply with all local, state and federal laws and guidelines including OSHA, ADA, EOE, FMLA, CLIA, COLA, JCAHO, FACTA, HIPAA, Stark I, II & III, fire safety, crash carts and defibrillators, disaster communication, sexual harrassment, universal precautions, MSDS hazards, confidentiality, security and privacy, and provide staff with documentation and training in same. Make sure all clinical staff are current on licenses and CPR. Have downtime procedures for loss of computer accessibility. Make sure risk management policies are being followed. Alert malpractice carrier to any potential liability issues immediately. Make sure medical records are being stored and released appropriately.
Accounting: Pay bills, produce payroll, prepare compensation schedules for physicians, prepare and pay taxes, prepare budget and monthly variance reports, make deposits, reconcile bank statements, reconcile merchant accounts, prepare Profit & Loss statements, prepare refunds to payers and patients, and file lots and lots of paperwork.
Billing, Claims and Accounts Receivable: Perform eligibility searches on all scheduled patients. Ensure that all dictation is complete and all encounters (office, hospital, nursing home, ASC, satellite office, home visits and legal work (depositions, etc.) are charged and all payments, denials and adjustments are posted within pre-determined amount of time. Transmit electronic claims daily. Send patient statements daily or weekly. Negotiate payer contracts and ensure payers are complying with contract terms. Appeal denials. Have staff collect deductibles, co-pays and co-insurance and have financial counselors meet with patients scheduling surgery, those with an outstanding balance, or those patients with high deductibles or healthcare savings plans. Make sure scheduling staff know which payers the practice does not contract with. Liaison with billing service if billing is outsourced. Credential care providers with all payers. Perform internal compliance audits. Load new RBRVS values, new CPTs and new ICD-9s annually. Run monthly reports for physician production, aged accounts receivable, net collection percentage and cost and collections per RVU. Attach appropriate codes to claims for e-prescribing and PQRI. Have plan in place for receipt of Recovery Audit Contractor (RAC) letters. Make friends and meet regularly with the provider reps for your largest payers.
Marketing: Introduce new physicians, new locations and new services to the community. Recommend sponsorship of appropriate charities, sports and events in the community. Recommend sponsorship of patient support groups and keep physicians giving talks and appearing at events. Thank patients for referring other patients. Track referral sources. Recommend use of Yellow Pages, billboards, radio, television, newspaper, magazine, direct mail, newsletters, email, website, blog, and other social media. Prepare press releases on practice events and physicians awards and activities. Recommend practice physicians for television health spots.
Strategic Planning: Prepare ROIs (Return on Investment) and pro formas for new physicians, new services, and new locations. Forecast potential effect of Medicare cuts, contracts in negotiation or over-dependence on one payer. Discuss 5-year plans for capital expenditures such as EMR, ancillary services, physician recruitment, and replacement equipment. Explore outsourcing office functions or having staff telecommute. Always look for technology that can make the practice more efficient or productive.
Day-to-day Operations: Make the rounds of the practice at least twice a day to observe and be available for questions. Arrange for temporary staff or rearrange staff schedules for shortages, meet or speak with patients with complaints, and meet with vendors, physicians and staff. Open mail and recycle most of it. Unplug toilet(s).
Stay Current in Healthcare: Attend continuing education sessions via face-to-face conferences, webinars, podcasts and online classes. Maintain membership in professional organizations. Pursue certification in medical practice management. Network with community and same specialty colleagues. Participate in listservs, LinkedIn and Twitter.
What did I leave out? Take a lunch?
Read my post on “How Much Do Medical Practice Managers Make?” here.
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gee – that sounds so easy
That nearly covers everything. I would add “Red Flag Rules” to the Legal category. But, this is the most comprehensive list I have seen thus far!
Wow Mary, pretty comprehensive list. When people ask me what I do as a practice manager, I tell them that my job is to make sure the office runs smooth. Now, I can just point them to your blog.
Thanks, Brandon. Putting it altogether like this made me both proud to be in this profession, and amazed at what we do!
Mary Pat
This is a fantastic primer for building an understanding of a “day in the life of.” Thank you!
Hopefully a manager wouldn’t have to do everything on that list in one day, but some days it does feel like it!
Best wishes,
Mary Pat
Love it…unfortunatly it is true
Thank you for posting. I’m thinking about becoming a healthcare manager, and you post is very helpful!
Hi Mary,
I’m glad to hear it was helpful. Let me know if I can help you in your journey.
Best wishes,
Mary Pat
[...] and more! (see my post on what managers do here.) [...]
Hello Mary,
Great article. I have a question though. In your vast experience with practice managers, what is the downside to hiring someone with military experience only as a practice manager?
From what I have read here and my knowledge and backgraound as a Navy Hospital Corpsman, the only significant difference is the volume of Third Party Reimbursement activities between military and civilian practices/ medical organizations.
What are your thoughts?
Hi Gary,
What a great question! Hiring a manager who does not have any direct experience with third-party payers could be considered a risk if the practice is relying completely on the manager to negotiate contracts, monitor payer performance and go toe-to-toe with the payer when the contract terms are being abused. No manager is strong in every aspect of practice management so often a practice will augment a manager’s experience with some additional training or education, or will bring a specialist on board (an experienced billing manager) or use a consultant.
Tell me about asking this question – what has your experience been?
Best wishes,
Mary Pat
Hi Mary Pat,
Love your blog! Question for you. I am a nurse consultant and have developed a training program for medical office staff to become more efficient at prior authorization for advanced imaging. I do cold calling to medical offices to sell my training program and am in the process of hiring a salesperson to help me. Who in the office do you think I would have a better chance selling my services to? The person actually doing the prior auths, office manager or the medical provider? Any advice would be so appreciated! Thanks!
Hi Terri,
Thanks for your questions. Your training program sounds great. Unless a physician is very deeply involved in the billing and day-to-day operations, I would not propose marketing to him/her. The two most likely candidates for understanding the value a program like yours could bring to the table are the manager/administrator or the billing manager, if the practice is big enough to have one. Selling to the person who actually does the pre-authorizations might be hit or miss, depending on their knowledge base and their relationship with decision makers. I hope this is helpful.
Best wishes,
Mary Pat
Thanks so much for the advice! Yes, very helpful. Do you mind if I list a link to your blog on my blog and website? Your info is very relevant and spot on. I also quoted you in a recent article I wrote. You can check it out on my blog under the link: “The Future of Health Care”.
Take care,
Terri
Thanks, Terri, for the quote and link. I’m glad I could be of help.
Best wishes,
Mary Pat
[...] Manager (see the Library tab for job descriptions) see my posts on what an administrator does here, and a day in the life of an administrator [...]