Readings

candidates for the position. Your job is to evaluate these managers and help Paul choose

the best new leader for the organization.

Important Facts to Know

The Ambulatory Care Center is a medium-sized facility serving an average of 80 patients

on a daily basis. There has been little growth over the last few years, and the direction of

the Center needs to change in order for it to remain viable. Historically, the Center has

served a predominance of senior citizens, reflective of the surrounding community; however, the neighborhood is changing. More and more young families are moving in, and

there are now many young adults and school-age children in the surrounding community.

Additionally, the ethnicity of the neighborhood is changing, with more and more families

of Hispanic or African American origin.

The financial base that supports the Center is gradually changing from payments that

come predominantly from Medicare and private pay to a financial base where payments

are mainly coming from a combination of group insurance, Medicaid, and cash patients.

Many of the adults work at the car manufacturing plant that was recently built in their city.

These individuals and their families have high-quality group insurance. The Center would

like very much to “tap into” this insured group and is interested in contracting with them

for services for their employees.

Because of these changes in the surrounding community and the resulting impact on

their financial base, the Center wants to change direction for the future. They wish to

redesign their image and how the community views them. They no longer wish to be identified as just a clinic mostly for seniors, but as a Center for all who need medical care.

The Center wants it to be known that they can care for all ages. They are particularly

interested in making sure that people are aware of the many services they can provide for

children, including newborn screening for metabolic, sickle cell, and other genetic disorders;

special programs for diabetic children; and specialty treatments for children with

ADHD, autism, and Asperger’s syndrome. The addition of a specialized pediatric group

to their physician base has made these services possible, and they want to get the word out

to the community as to their availability.

The Candidates

Candidate #1

The first person being considered for the new leadership job is Taneshia. She is an African

American woman, age 36, who has worked for the Center for the last three years. She has

her bachelor’s degree in health administration and is a registered record administrator. Her

college minor was in human resources management.

She is currently the director of health information management systems, has done well

in her job, and has increased reimbursement for the Center. One of the ways in which

Taneshia was able to increase the reimbursement figures was by implementing electronic

medical records in her department. The transition from paper to electronic record-keeping

has been difficult, but Taneshia is very good with technology, and she has led her department with a sure hand. The introduction of electronic medical records has also decreased record-keeping errors. Taneshia makes a point of keeping up-to-date with all the latest advances in her field of expertise. She is entrepreneurial and innovative.

Taneshia has a directive management style when she is training those under her.

Unfortunately, she is also somewhat pompous and opinionated and feels no one knows as

much about the work of her department, or about computers, as she does. However, the

training of her staff, despite her style, has achieved the goal of having her people do better and more accurate coding work. Correct coding has resulted in fewer appeals and more payments for the Center. She accomplishes her goals—but tends to push her people a little too hard. She has done outstanding work in regulatory compliance by volunteering to make sure that all reporting for the entire Center is completed. There was, at one point, some question as to whether her reporting methods were accurate or whether she was just reporting what the Department of Health wanted to hear. However, no improper conduct was ever proven, and the Center remains in good standing with the local regulators.

Additionally, she has created a strong liaison with the physicians by providing them with

extensive peer comparison statistics. She has created a great deal of transparency with her new and improved record-keeping methods, and this has motivated the doctors to work better and smarter. They have increased their productivity, and this has also helped to increase revenue.

Taneshia is married and has no children. At this time, she has no plans for a family.

She and her husband are busy with their respective careers. She is unsure if she wants to

pursue a further degree, such as a master’s. She works whatever hours are necessary to get the job done.

Candidate #2

The second person being considered for the new leadership job is Felipe. He is a Hispanic

male, age 29, who has worked for the Center for the last five years. He started with them

directly out of college and has worked his way up to where he is now—the director of community outreach. He has his bachelor’s in health administration, and he just finished

his master’s in business administration. His duties include marketing and contracting with managed care companies. He has done well in his job and is seen as a talented negotiator. He understands contracts and is good with people. He has signed a number of lucrative contracts for the Center.

Felipe has no employees directly reporting to him. However, now that he has his master’s

degree, he is interested in moving into operations in his next healthcare job. He feels that he would be good at leading, directing, and managing employees, and he would like to take on this added responsibility. He has already started to look around for new job possibilities.

Felipe has a participative management style, and he is professional in his demeanor. He

is well liked both at the Center and out in the community. He has improved the reputation

of the Center in the surrounding neighborhood simply with his engaging personality

and his involvement in community outreach. His youth, good looks, and charming personality have made him popular with his female employees; however, there has never been any hint of scandal associated with his name. Felipe is considered to have high integrity, and he cares deeply what people think of him.

Due to his external community focus, Felipe is not required to be at the Center on a daily

basis. He is expected, though, to be out in the field 40 hours per week developing new and

nurturing old business relationships. There were rumors that he was attending his MBA

classes when he was supposed to be working and did not have Paul’s permission to do so.

Felipe is single and has no intention of getting married anytime soon. He works many

hours of overtime and appears to be willing to go the extra mile and give the time necessary

to get something done.

Candidate #3

The third person being considered for the new leadership job is Amanda. She is a Caucasian

woman, age 45, who has worked for the Center for the last 10 years. She started as a front

office receptionist in order to “get in” and has worked her way up to the job of business

office manager. She has a bachelor’s degree in health administration. Amanda has a professional style and dresses well. She is a confident woman with a positive outlook on life. She is highly motivated to do a good job and motivates those around her.

Amanda oversees a large and varied group of workers, ranging from receptionists to billing

clerks. She has done well in her job and has increased reimbursement for the Center.

She has done this by first teaching and training those in her department to do effective

billing and collection, resulting in faster claims turnaround and fewer denials. Second,

she has improved information collection at the front desks. The receptionists now make

sure that all information on the intake forms is filled out completely, that copayments and

deductibles are collected, and that correct authorizations are in place before a patient is

seen. Amanda was instrumental in the purchase and installation of a new billing system

that helps her people do an excellent job.

Amanda is well liked by her employees. She has good coaching skills and gives her people

credit for their accomplishments. She rarely takes credit for herself. She has a great deal

of confidence and is able to easily instill confidence in those around her. She has integrity

and is well known throughout the Center as the “go to” person if you have a problem.

When the current leader is out of town on business or goes on vacation, Amanda fills in

for him. She has done this on numerous occasions.

Over the years, the employee base at the Center has gradually changed, and now there is

great variety in the ethnicity and nationality of the employees. Amanda is not that comfortable working with people of backgrounds different from her own. She is aware of this insecurity and is working to correct it by meeting and greeting all those who work for her on a daily basis. Because of her assertive leadership and the aggressive collection methods that she has her people use, both at the front desk and later via telephone collection, the patients tend to complain to their doctors. The doctors, in turn, complain to Amanda, asking her to “soft pedal” the requests for money. She has no sympathy and tells the doctors it is her job to collect money and she’s going to do it in every way that she can.

Amanda is married and has two adolescent children and a busy life. As a result, she has

never pursued her master’s degree. She has never felt she had the time. Because of her children, she rarely works past 5 p.m. She puts in her 40 hours faithfully and then heads for home.

Write a 150-word summary of what you have learned during this case study. Use the following question below to answer

· Which of the factors you consider important would most favor Taneshia? Felipe? Amanda?