hard business skills

knowledge, skills, abilities (K, S, & A's), certifications, Experience

overview
The sections below describe areas of healthcare business administration in which I have undertaken at least some formal training.

I selectively provided specific examples where I have work-related experience.

Selected abbreviations
- HCI = healthcare industry
- HCO = healthcare organization
- HCP = healthcare provider
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HCO revenue cycle
Knowledge of:

(1) reimbursement and documentation processes for Medicare's:
- inpatient PPS
- outpatient PPS (for clinics, HOPDs, ASCs)
- PACPPS (LTACHs, SNFs, HH)
- HCP and ambulance retrospective payments
- value-based payment systems
- alternative payment systems
- other payment systems (e.g., Hospice)
(2) and also:
- US government healthcare insurance plans
- managed care and private insurance plans
- ICD-10
- revenue cycle management techniques
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managerial and financial accounting
K, S, & A's regarding:
- financial statement creation and interpretation
- margins analysis
- costing method application
- financing, leasing, and amortization application
- breakeven analysis and investment appraisal (NPV, ROI, IRR, PI, PBP)
- operating and capital budget creation
- business plan creation
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HCO microeconomics
Knowledge about:
- measuring and determining market power, supply, demand, deficit, and surplus regarding goods, services, and labor
- price elasticity and rigidity
- health insurance effects on patient demand for healthcare services
- competition/concentration effects on healthcare prices and quality
- economic analyses (EIA, PCA, BCA, CEA, CUA)
- socioeconomic disparities
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human resource management
K, S, & A's regarding:
- costs of hiring and firing determination
- setting recruiting, interviewing, and candidate selection criteria
- labor:work ratio evaluation
- use of job change matrices and labor shortage and surplus assessment
- advantages and disadvantages of organizational power structures (governance) and communication structures
- job and workflow design strategies
- job description creation and use
- employee training
- employee performance monitoring
- employee motivation, demotivation, and goal setting
- employee engagement and satisfaction improvement
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project management
K, S, & A's regarding:
- the Project Management Institute's PMBOK 7th ed. contents (most of the PMI's 60 tools and 74 artifacts, like a project charter, stakeholder register, work breakdown structure, burn chart, and Gantt chart)
- chartering and stakeholder analysis
- scheduling and schedule crashing
- resourcing and budgeting
- risk and quality planning
- supply chain management
- Agile vs. waterfall approaches
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HCO quality management
Certification :
- National Association of Healthcare Quality
Experience:
- I have used Lean and Six Sigma strategies at multiple hospital radiology departments.
K, S, & A's in HCO quality management:
- run charts, including control charts... the tool that HCOs most under-use
- bar charts (Pareto)
- flow charts/flow maps/algorithms
- true maps (spaghetti)
- matrices (FMEA)
- checklists (SMART aims)
- scoring systems (net promoter score)
- design of experiments
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leadership
Experience:
I have led diagnostic and interventional radiology teams of nurses and technologists at multiple hospitals since 2014.

Knowledge regarding:
- directing team dynamics
- resolving conflict (relationship, status, task, process)
- setting organization culture
- leadership theory other (Drucker)
- see also the overlapping entries in the more specific management areas
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organization strategy
Experience:
- writing strategic plans (please see my CV skills section)
Knowledge regarding:
- competitor analysis resources
- market entry forces and value chain links (Porter)
- mission alignment/linkage (e.g., with IT and HR)
- pre-implementation strategy types (Glueck, David)
- tools for evaluating strategy types
- balanced scorecards
- outsourcing
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HCI vs. other industries:
Knowledge of how an HCO can look outside the HCI to improve its:
- customer service (e.g., hospitality)
- automation (e.g., manufacturing)
- digital readiness (e.g., travel)
- regulatory auditing (e.g., professional athletics)
- safety (e.g., airlines)
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HCO and physician (particularly radiology) risk management
Certification :
American Society for Healthcare Risk Management / American Hospital Association

Familiarity with:

Pay for performance law
- 2015: Medicare Access and CHIP Reauthorization Act
Corruption, fraud, abuse, and anti-trust laws/regulations
- 2009: MFSRP
- 2007: MMSEA 111
- 2002: Sarbanes-Oxley Act
- 1989: Stark
- 1986: anti-kickback
- 1914: Clayton Act
- 1890: Sherman Act
- 1863: False Claims Act
- other federal laws, CMS conditions of participation, and other regulations affecting medical billing and billing compliance
Other HCO-specific laws of the last 50 years (numerous... only several listed here)
- 2015: MACRA
- 2012: PPACA
- 2009: HITECH
- 2005: PSQIA
- 2005: DRA
- 2003: MMA
- 1998: CLIA
- 1996: HIPAA
- 1990: SMDA
- 1986: EMTALA
- 1986: HCQIA
- 1982: TEFRA
- common law decisions related to HCO and physician professional liability
Employment discrimination, endangerment, and harassment laws
- 2009: Lilly Ledbetter Fair Pay Act
- 1993: Family and Medical Leave Act
- 1990: Americans with Disabilities Act
- 1978: Pregnancy Discrimination Act
- 1974: Employee Retirement and Income Security Act
- 1970: Occupational Safety and Health Act
- 1967: Age Discrimination in Employment Act
- 1964: Civil Right Act Title VII
- 1963: Equal Pay Act
- 1938: Fair Labor Standards Act
- 1868: 14th Constitutional Amendment
- 1865: 13th Constitutional Amendment
American Society for Healthcare Risk Management certification
healthcare policy and regulation 'other'
Familiarity with issues such as:
- underprevention and overtreatment
- medical error epidemic
- payment systems/models: prospective, retrospective, value-based, capitated, private, public, universal, employer-based, and combinations
- options for healthcare system improvement based on international healthcare policies (e.g., cost reduction, health outcomes)
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public health
Knowledge regarding:
- CDC, AHRQ, and other federal and state organizations that affect healthcare
- public health institutes and population health measures
- community needs assessments
- county and census tract analysis
- epidemiology concepts: incidence, prevalence, attributable risk, mortality rate, social determinants of health
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statistics and experiment design
Experience:
- Please see the website quality page and my CV.
K, S, & A's regarding:
- data types
- measures of frequency, location, spread, probability, and reliability
- tests of correlation vs. differentiation and when they should be used
- criteria for determining causation
- design of experiments (DOE)... both business experiments and scientific experiments
- minimizing chance, bias, and confounding variables
design of experiments
information systems and technology
Experience using EHRs such as:
- Cerner
- Epic
- Meditech
- eClinicalWorks
Knowledge regarding:
- EHR effects on HCO performance
- data mining software and algorithms
- automation (e.g., EHR coding automation)
- dashboards
- networks, including layers and layer defense strategies (cybersecurity)
- deep learning (AI)
- personal health monitoring devices
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radiology/medical imaging

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Email the address below or use the Contact form on this website for information on:

- speaking events.

- educational seminars.

- professional consultation.

heroes@howdoctorsbecomeheroes.com

knowledge, skills, abilities (K, S, & A's), certifications, Experience

Check back frequently for updates... Icons are courtesy of flaticon.com.

Check back frequently for updates...
Icons are courtesy of flaticon.com.