Internal promotions can enhance PFS strategic success - patient financial services

Healthcare Financial Management, April, 2002 by Bobette M. Gustafson

Today's patient financial services (PFS) directors frequently face the challenge of selecting and developing new middle managers. Like many PFS directors themselves, the chosen candidate often is a former member of a functional PFS team. This individual typically is promoted to middle management because he or she is respected within the department and organization as an operational superstar who possesses advanced technical knowledge, team spirit, and personal motivation and consistently achieves high productivity and quality levels.

Such operational skills and traits certainly are excellent foundations for managerial achievement. To ensure that newly promoted managers succeed in their new roles, however, PFS directors must assess the individuals' capabilities and establish an appropriate development plan to help them achieve their full potential and meet their new responsibilities.

Internal Promotion Case Study

Consider the fictitious case, for example, of Jim Smith, billing specialist, who has been selected as the new PFS supervisor based on his excellent work record. Jim is known for always completing his work assignments expeditiously and for regularly accepting additional duties. In his previous position, he also used his detailed technical knowledge to flag errors made by coworkers. Jim has agreed to assume first-line responsibility for leading all billing activities and staff.

Like most new, internally promoted managers, Jim primarily was an individual contributor in his previous position, typically relying upon upward communication lines. Jim's immediate supervisor was his main source of information. He maintained relationships with a limited number of coworkers doing similar tasks, while his supervisor implemented necessary changes and solved problems involving Jim's coworkers or other functional teams. Jim's training has been limited primarily to technical areas related to his work assignments.

Until now, most of Jim's success has been due to his technical skills--the processes, tools, and techniques he used to perform tasks within his assigned work area. In his previous, nonleadership role, Jim used his knowledge and abilities to review and correct claim-edit failures and eliminate backlogged bill inventories by submitting claims in compliance with each known payer's requirements.

As a new leader, Jim must move beyond these detailed billing responsibilities by acquiring the new, more advanced technical skills and knowledge associated with achieving results through and with others. Rather than eliminating billing backlogs on his own, he must develop billing tools for his staff's use. For example, he may need to learn how to develop a productivity report, which his staff would use to document the number of claims pending edit resolution. Jim also likely will require the ability to create a spreadsheet to project cash flow during the backlog and resolution period. He will need the business writing skills necessary to compose effective policy and procedural documents regarding the employees' use of the productivity report, as well as memorandums communicating cash-flow information to his director and other organizational leaders. Most newly promoted leaders lack education in these technical areas.

Jim's success as a new middle manager and his potential for further advancement will depend upon his ability to shift priorities and gain new expertise in human relations and conceptual skills. Organizational development specialists report that, as leaders advance to higher levels of responsibilities, technical capabilities become secondary to human relations and conceptual skills.

Human relations skills ensure that Jim will successfully interact and communicate with individuals and groups at all levels, including those who report directly to him and those who do not. Human relations skills will help Jim motivate his staff members to routinely use the new productivity reporting tool to honestly report their backlogged claim inventories. These critical interaction and communication skills also will enable him to effectively discuss with his new peer, the access supervisor, the claim submission backlogs related to registration errors and develop a process for regularly reporting these problems.

Jim also will need to develop his conceptual skills, which will allow him to see the organization as a whole and understand how various functions relate to and depend upon one another. This broader perspective will let him deal more effectively with abstract ideas and identify strategic solutions.

For example, Jim's efforts to address the backlogged claim inventories will go beyond those already discussed. He likely will need to identify and evaluate the core reasons for the registration errors, such as inappropriate selection of registration staff lacking critical competencies, deficient registrar training or procedural documentation, inadequate policies or communication of registration protocols to referring physicians, or the absence of automated system edits to flag deficiencies at the time of registration.