Pauline 'Polly' James

Purpose

The purpose of my role is to lead and manage the Revenue Partnering Project to meet organisational objectives and maximise revenue generation and performance across NSW.

Key Responsibilities

• Promote a holistic approach to revenue, supporting health entities with the non-financial aspects of revenue including best practice, governance, compliance, capability development, and improving accountability for revenue.
• Engage with health entities to identifying key focus areas and initiatives to maximise own source revenue and reduce budget deficits.
• Collaborate with health entities to improve standardisation and transparency of processes.
• Identify and lead the implementation of materials to improve own source revenue generation and collection for the state.
• Work with the Commonwealth Hospital Compliance team, health entities, and other jurisdictions to ensure that NSW Health billing compliance rules are robust, clearly understood, and actioned.
• Providing support and guidance relating to subjects within my area of expertise, including preparing reports relating to Medicare billing in public hospitals, compliance, and non-admitted patient services.

Achievements

• Improving revenue performance by providing structured support to stakeholders.
• Implementing a strong governance framework to minimise risk and ensure compliance.
• Development of dedicated resources to support clinicians exercising their rights of private practice across NSW.
• Development and launch of the Ministry of Health Revenue Mentor Program to support new and emerging leaders across NSW.

Purpose

The purpose of this role is to lead the district in all activities associated with generating and collecting own-source revenue. Leading improvement of revenue management performance and the development and implementation of strategies to identify new revenue opportunities, so that the district's own source revenue budget is achieved.

Key Responsibilities

• Maximise revenue collection throughout the district.
• Liaise with other health entities to improve revenue performance and contribute to the MOH direction in policy decisions regarding revenue.
• Ensure billing and revenue collection adheres to MOH and CCLHD policy and procedures and other legislative requirements.
• Develop, implement and review policies and procedures and develop training initiatives to improve education and knowledge of revenue collection, budgeting and accounting.
• Coordinate activities and resources that support improved operating practices that are consistent with Ministry of Health and CCLHD policies and procedures and legislative requirements.
• Coordinate and respond to urgent and ad hoc requests relating to revenue processes from with within the District, the Ministry of Health, the Minister's Office and audit requirements.
• Lead and empower staff to deliver a multi-site, customer focused service to meet operational and reporting requirements.
• Lead and develop revenue processes, provide advice and guidance to ensure managers make well informed decisions on revenue matters.

Achievements

• Improved end of month reporting processes providing accurate data to the Director of Finance and the Board.
• Streamlined debt recovery process by implementing process change looking at the debt holistically, rather than individual invoices to reduce the age of bad debt.
• Development and implementation of training initiatives to improve education and knowledge of revenue collection.
• Improved of invoicing process for Nursing Home Type patients reducing bad debt and negative feedback and improving relationships with stakeholders.
• Successfully completion and submission of the annual revenue requirements for the Conditions of Submission Financial Year 2022-23.
• Improving the awareness of the importance of own source revenue across the district.
• Increasing accountability of stakeholders external to Revenue for own source revenue.

Purpose

The purpose of this role is to facilitate the smooth financial on boarding of all senior medical officers commencing across the district, and to deliver a centralised revenue and billing point of contact, providing support and education on an individual basis.

Key Responsibilities

• Ensure Medicare and Ministry of Health compliance.
• Ensure senior medical officers who perform services for privately referred non-inpatient are configured into the systems in a timely to maximise revenue generation.
• Negotiation and implementation of Licence Agreements for Visiting Medical Officers (VMOs) and Record of Activity for Staff Specialists exercising their Rights of Private Practice ensuring facility fees are being generated and distributed to the correct cost centres.
• Centralised revenue and billing contact for senior medical officers, to provide advice, support and education.
• Provide support and information to the Manager, Revenue Generation & Processing.
• Provide advice and support to stakeholders including Medical Workforce, District Director of Medical Services, General Managers and the Executive Team.

Achievements

• Development and implementation of local resources to support new senior medical officers.
• Development and implementation of standard of documentation to record financial arrangements for all senior medical officers.
• Development and implementation of a 5-step process to guide the set-up of new non-admitted service.
• Building strong relationships with external stakeholders with the joint purpose of supporting senior medical officers.

January 2019 – Role expansion to Practice & Administration Manager, Specialist Clinics, Gosford Hospital

Purpose

The purpose of this role is to provide leadership and management for the operation of the Central Coast Specialist Centre and professional management to Administration Staff in Specialist Clinics within Gosford Hospital.

Key Responsibilities

• Provide expert advice on the set up of clinics with respect to revenue generation (district and clinicians via rights of private practice), Medicare compliant billing, staff management and monitoring the viability of the clinics.
• Implement strategic initiatives designed to create and maintain the highest standard of medical practice.
• Provide direction, support and feedback to management to facilitate the delivery of quality outcomes against organisation objectives.
• Ensure compliance with all relevant legislation.

Achievements

• Implemented changes to room allocation and effective utilisation to improve patient access.
• Implementing changes to referral management processes to increase billable services.
• Recognition for creating a positive workplace culture within the district.
• Improved relationships with clinicians build on trust and confidence of my knowledge, experience and decision making.