This Grade V role will initially be assigned to the Private Health Insurance office.

Improve and maximise the income of the Hospital and minimising rejected insurance claims.  

To provide leadership on all aspects of private income, working closely with the Finance Department to achieve KPI’s.

To embed the collection of private income processes for both scheduled and unscheduled care pathways.

Generate reports and data sets as per the Executive Management team request.

To provide business planning support in the operational and strategic development of private income at Connolly Hospital.

To provide operational management of clinical administration staff and relevant areas as designated. 

The RCSI Hospital Group includes the following hospitals: 

• Beaumont Hospital
• Cavan General Hospital
• Connolly Hospital, Blanchardstown
• Louth County Hospital
• Monaghan General Hospital
• Our Lady of Lourdes Hospital
• Rotunda Hospital
• The Academic Partner for the Group is the RCSI

RCSI Hospital Group provides a national service and a regional service to Dublin and the North East and is committed to the provision of world-class care, exceptional clinical services with respect and compassion.

Connolly Hospital is one of 8 hospitals in the RCSI Hospitals Group covering a population of over 800,000 people.  Connolly Hospital’s Catchment Population of over 331,000 covers Dublin West, North Kildare and South Meath.

Connolly Hospital Blanchardstown is a major teaching hospital providing a range of acute medical and surgical services, day care, outpatient, diagnostic and support services.  Emergency services are provided on a 365-day, 24 hour basis.  Multi-disciplinary teams representative of medical, nursing, allied health professionals, management and general support staff play a pivotal role in the development, delivery, monitoring and evaluation of these services.  The hospital has a current bed complement of >300 beds.

The hospital is affiliated to the Royal College of Surgeons in Ireland (RCSI) for medical education, to Dublin City University (DCU) for nursing education and to University College Dublin (UCD), Trinity College Dublin (TCD) and the Institute of Technology for allied health professional education.

Connolly Hospital is one of 8 hospitals in the RCSI Hospitals Group covering a population of over 800,000 people.  Connolly Hospital’s Catchment Population of over 331,000 covers Dublin West, North Kildare and South Meath.

The Academic Partner for the Group is the RCSI.

The Post Holder will:

Identify new emergency admissions to the hospital:

• Collect all private claims forms from ED each morning and identify that these claims have been completed correctly.
• Verification of insurance patient policies with the Private Insurance Patient Verification System to confirm their eligibility is current and valid.
• Identify patients who have not signed their private forms and ensure that these patients are followed up on the ward in a timely manner.

Meet new hospital admissions daily:

• Any patient who has been admitted with private insurance and no forms have been completed on admission the P.I.O. must make contact with this patient by visiting them on the ward and discuss their eligibility with them. If the patient is not coherent, then the Next of Kin must be contacted in relation to their family member’s eligibility and signing of forms.
• For those patients with dual cover the PIO must explain the benefits/advantages of using their PHI.
• If the patient refuses to sign their private forms it is the responsibility of the PIO to make contact with the Bed Manager and inform her/him of the patient decision to ensure patient does not accommodate a private/semi private room. Notes also must be updated on this patients records in Claimsure and IPMS.
• It is also the responsibility of the PIO to follow up on incorrect completion of claim forms.

PHI Policies:

• Ensure that the patients PHI policy is sufficient to cover inpatient Multi Occupancy cover within the hospital. Assess the eligibility of a patient by accessing the Insurers’ webs.  If policies are not valid PIO must make contact with patient to discuss this.
• Work in conjunction with the Bed Manager to ensure PHI patients are admitted to wards in a timely manner thus maximising revenue.
• Ensure that the utilisation of single occupancy beds is optimised.

Elective Patients:

• Review in advance of admission the eligibility status of elective admissions. Seek to have eligibility checked and completed in advance of admission. Send out claims forms to patients prior to their elective admission and follow up when admitted. 

Data Base records re private patients:

• Record on a daily basis the number of private patients admitted on a summarised spreadsheet so that trends re private income can be easily identified.

Data & Performance Management

• Provide reports on hospital activity and performance as required by the Hospital Manager on a regular basis
• Identify and develop KPIs consistent with Connolly Hospital’s service plan and the overall objectives of the RCSI hospital group
• Manage the delivery of KPIs as a routine and core business objective / develop Action Plans to address non-attainment of KPI targets
• Monitor and track performance targets and develop internal and external comparative performance monitoring information to support and inform decision-making hospital wide.
• Ensure that the quality of data regarding all activity within the sphere of responsibility is of the highest quality.

People & Resource Management

• Effective professional and operational management of clinical administration staff as designated.
• Review and analyse clinical administrative resource requirements across critical services and be responsive to service developments
• Develop training and education plan encompassing mandatory, corporate and personal development objectives to realise the capabilities and contribution of all staff
• Review Consultant practice plan

Quality Assurance

• Contribute to the coordination of the Hospital’s self-assessment against the National Standards and promote awareness towards achieving a strong culture of Safety and Continuous Quality Improvement in the Hospital
• Monitor and coordinate a programme of audit within the Hospital
• Evaluate the Clinical Administrative Systems and Processes to ensure adherence to Standards (Local, National and International).
• Contribute to the development and lead on the implementation of best practice service modernisation and improvement plans and strategies as required.
• Continuously evaluate the effectiveness of services and introduce related changes where appropriate
• Ensure compliance with legislation
• Have a strong working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etc.

Quality & Patient Safety

• Familiarise themselves with the relevant organisational policies, procedures & standards and attend training as appropriate in the following areas:
• Continuous Quality Improvement Initiatives
• Risk Management Strategy and Policies
• Hygiene Related Policies, Procedures and Standards
• Decontamination Code of Practice
• Infection Control Policies
• Healthcare Audit as part of the MDT
• Safety Statement, Health & Safety Policies and Fire Procedure
• Data Protection and confidentiality Policies

Eligible applicants will be those who on the closing date for the competition:

Have obtained a pass (Grade D) in at least five subjects from the approved list of subjects in the Department of Education Leaving Certificate Examination, including Mathematics and English or Irish1. Candidates should have obtained at least Grade C on higher level papers in three subjects in that examination.

or

Have completed a relevant examination at a comparable standard in any equivalent examination in another jurisdiction.

or

Hold a comparable and relevant third level qualification of at least level 6 on the National Qualifications Framework maintained by Qualifications and Quality Ireland, (QQI).

Note1: Candidates must achieve a pass in Ordinary or Higher level papers. A pass in a foundation level paper is not acceptable.  Candidates must have achieved these grades on the Leaving Certificate Established programme or the Leaving Certificate Vocational programme.  The Leaving Certification Applied Programme does not fulfil the eligibility criteria.

And

Candidates must possess the requisite knowledge and ability, including a high standard of suitability for the proper discharge of the office.

Health

A candidate for and any person holding the office must be fully competent and capable of undertaking the duties attached to the office and be in a state of health such as would indicate a reasonable prospect of ability to render regular and efficient service.  

Character

Each candidate for and any person holding the office must be of good character.

Age

The Public Service Superannuation (Age of Retirement) Act, 2018* set 70 years as the compulsory retirement age for public servants.

       * Public Servants not affected by this legislation:

        Public servants recruited between 1 April 2004 and 31 December 2012 (new

         entrants) have no compulsory retirement age.

Public servants recruited since 1 January 2013 are members of the Single Pension Scheme and have a compulsory retirement age of 70.

POST SPECIFIC REQUIREMENTS

Candidates must

• Proven track record of leading and delivering projects on time that are innovative and drive improvement in a health care setting or related service.
• Proven, documented experience of complex data interrogation and statistical analysis in a multi-faceted organisation including high level of accuracy and attention to detail, and the ability to deliver analytical outputs to a high standard.
• A demonstrated record of supporting the delivery of change and experience of managing and working collaboratively with multiple stakeholders.
• Operational knowledge of a hospital with proven track record in leadership and managing change projects.
• Possess sufficient administrative capacity to discharge the functions of the grade
• Proven track record of leading and delivering projects on time that are innovative and drive improvement in a health care setting or related service
• A demonstrated record of supporting the delivery of change and experience of managing and working collaboratively with multiple stakeholder
• Possess sufficient knowledge of Private Health Insurance
• 2 years’ experience in an acute hospital

Technical & Professional Expertise

Has a command over the technical/ professional skills and knowledge required within the job holder’s role and continues to upskill to maintain high professional standards and continuous professional development requirements

Results Driven & Accountable

Focuses on delivering results, always concerned with achieving or surpassing goals and/or recognised standards of performance.

Communications & Interpersonal Skills

Speaks and writes clearly, fluently and effectively to both individuals and groups; communicates in a manner that will persuade, convince and influence others, in order to motivate, inspire or encourage them to follow a particular course of action.

Evaluating Information, Problem Solving & Decision Making

Identifies and solves problems by understanding the situation, seeking additional information, developing and weighing alternatives, and choosing the most appropriate course of action given the circumstances.

This Job Description is intended as a basic guide to the scope and responsibilities of the position and is subject to regular review and amendment. The role holder will be required to be flexible in this position and is expected to facilitate working additional hours on occasion, when requested.

The RCSI Hospital Group is an Equal Opportunities Employer.

A panel may be formed from this campaign to fill any future vacancies in the Finance Department.