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Процессная модель APQC Healthcare Provider (Медицинское учреждение)

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Процессная модель APQC Healthcare Provider

Рисунок 1. Процессы верхнего уровня модели APQC Healthcare Provider

Перечень процессов модели APQC Healthcare Provider приведен ниже.

1. Develop Vision and Strategy

    1.1. Define the long-term vision and values

      1.1.1. Assess the external environment Define and prioritize Service Areas Determine market share, patient origin, and outmigration Analyze and evaluate competition Identify economic and industry trends Identify political and regulatory issues Assess new technology innovations Analyze demographics Identify social and cultural changes Identify ecological concerns

      1.1.2. Survey market and determine community's needs, wants and perceptions of provider Conduct qualitative/quantitative assessments Capture and assess community needs Analyze Service Area utilization Project community medical demand Apply and obtain Certificate of Need

      1.1.3. Perform internal analysis Analyze organizational characteristics Create baselines for current processes Evaluate operational trends Analyze systems and technology Analyze financial positions Identify enterprise core competencies Determine the adequancy of access to care Determine the efficiency and effectiveness of care delivered Analyze services referred to an outside provider organization Analyze Provider utlization rates Project service line demand Determine staff needs (e.g. clinical, administrative, etc.)

 Review current skillsets

 Determine skillsets gaps

      1.1.4. Establish strategic vision Align stakeholders around strategic vision Communicate strategic vision to stakeholders

      1.1.5. Conduct organization restructuring opportunities Identify restructuring opportunities Perform due-diligence Analyze deal options

 Evaluate acquisition options

 Evaluate merger options

 Evaluate de-merger options

 Evaluate divesture options

    1.2. Develop business strategy

      1.2.1. Develop overall mission statement Define current business Formulate mission Communicate mission Identify competitive value position

      1.2.2. Establish organizational values Define organizational values Formulate values Communicate values

      1.2.3. Evaluate strategic options to achieve the objectives Define strategic options Assess and analyze impact of each option Develop sustainability strategy Develop global support and shared services strategy Develop lean/continuous improvement strategy

      1.2.4. Select long-term business strategy

      1.2.5. Coordinate and align functional and process strategies

      1.2.6. Create organizational design (structure, governance, reporting, etc.) Evaluate breadth and depth of organizational structure Perform job-specific roles mapping and value-added analyses Develop role activity diagrams to assess hand-off activity Perform organization redesign workshops Design the relationships between organizational units Develop role analysis and activity diagrams for key processes Assess organizational implication of feasible alternatives Migrate to new organization

      1.2.7. Develop and set organizational goals

      1.2.8. Formulate business unit strategies

    1.3. Manage strategic initiatives

      1.3.1. Develop strategic initiatives

      1.3.2. Evaluate strategic initiatives

      1.3.3. Select strategic initiatives

      1.3.4. Establish high-level measures metrics for success

2. Develop and Manage Healthcare Services

    2.1. Manage service portfolio

      2.1.1. Evaluate performance of existing services against market opportunities and evidence-based medicine

      2.1.2. Define service development requirements Identify potential improvements to existing services Identify potential services

      2.1.3. Confirm alignment of service concepts with business strategy Plan and develop cost and quality targets Prioritize and select new service concepts Specify development timelines and key milestones Plan for service offering modifications

      2.1.4. Manage service life cycle Go-live with new services Phase out outdated services Identify and refine key performance indicators

      2.1.5. Manage service cost and quality Analyze treatment pathways for patient populations Enhance treatment pathways with evidence-based practices Monitor and evaluate outcomes for enhanced treatment pathways Track compliance with enhanced treatment pathways

    2.2. Develop services

      2.2.1. Perform medical research Identify new or improved medical therapies, diagnostics and treatments Develop new medical therapies, diagnostics, and treatments Assess feasibility of integrating new medical therapies, diagnostics, and treatments service offerings Engage Research Sponsor and/ or Partner(s) Facilitate clinical trials

      2.2.2. Design, build business case, and evaluate services Assign resources to service project Prepare high-level business case, technical, and process assessments Develop service market, regulatory, and process specifications Document service market, regulatory, and process specifications Conduct mandatory and elective external reviews (legal, regulatory, standards, market) Map future state processes Eliminate quality/reliability problems and inefficiencies within the process Identify design/development performance indicators

      2.2.3. Test market for new or revised services Prepare detailed market study Conduct patient tests, interviews, and focus groups Finalize service characteristics, business cases, and future state processes Finalize regulatory, technical, and process requirements Identify requirements for changes to delivery processes

3. Market Healthcare Services

    3.1. Understand patients, markets, and capabilities

      3.1.1. Perform patient and market intelligence analysis Conduct patient and market research Identify patient and market segments Stratify patient populations based on risk criteria Analyze market and industry trends Analyze competing organizations, competitive/substitute services Evaluate existing services/brands Assess internal and external business environment

      3.1.2. Evaluate and prioritize market opportunities Assess immediate population health care needs Quantify market opportunities Determine target segments Prioritize opportunities consistent with capabilities and overall business strategy Validate opportunities

    3.2. Develop marketing strategy

      3.2.1. Define offering, patient and referral value proposition Define offering and positioning Develop value proposition including brand positioning for target segments Validate value proposition with target segments Develop branding

      3.2.2. Define and manage channel strategy Evaluate channel attributes and partners Determine channel fit with target segments Select channels for target segments

    3.3. Develop and manage marketing plans

      3.3.1. Establish goals, objectives, and metrics for services by channels/segments

      3.3.2. Establish marketing budgets Confirm marketing alignment to business strategy Determine costs of marketing Create marketing budget

      3.3.3. Develop and manage traditional/digital/ social media Define media objectives Develop marketing messages Define target audience Engage media provider Develop and execute advertising Develop and execute other marketing campaigns/programs Assess brand/ service marketing plan performance

      3.3.4. Develop and manage promotional activities/ sponsorships Define promotional concepts Plan and test promotional activities Execute promotional activities Evaluate promotional performance metrics Refine promotional performance metrics Incorporate learning into future/planned promotions

      3.3.5. Track patient management measures Determine patient loyalty/lifetime value Analyze patient revenue trend Analyze patient attrition and retention rates Analyze patient metrics Revise patient strategies, objectives, and plans based on metrics

    3.4. Develop and manage business development plans

      3.4.1. Generate leads Identify potential referrals Identify leads

      3.4.2. Manage referrals and accounts Develop key account plan Manage referral relationships Manage referral master data

      3.4.3. Manage referral marketing Perform referral generation calls Establish a referral source Record outcome of referral process

      3.4.4. Establish referral goals and measures

      3.4.5. Establish referral management measures

4. Deliver Healthcare Services

    4.1. Manage non-medical services

    4.2. Plan for and align supply chain resources

      4.2.1. Develop supply chain strategies Define supply chain goals Define material policies Define materials utilization policies Define outsourcing policies Define capital expense policies Define capacities Define supply constraints

      4.2.2. Manage demand for materials Develop baseline forecasts

 Identify product needs and equivalencies

 Review value benefit of materials Collaborate with internal customers Develop consensus forecast Determine availability to fulfill Determine anticipated materials utilization Monitor activity against forecast and revise forecast Evaluate and revise forecasting approach Measure forecast accuracy

      4.2.3. Create materials plan Create unconstrained plan Collaborate with suppliers and contract manufacturers Identify critical materials and supplier capacity Monitor material specifications Generate constrained plan

      4.2.4. Plan distribution requirements Maintain master data Determine product inventory requirements at destination Calculate requirements at destination Calculate consolidation at source Manage collaborative replenishment planning Manage requirements for partners Calculate destination dispatch plan Manage dispatch plan attainment Calculate destination load plans Manage partner load plan Manage cost of supply Manage capacity utilization

      4.2.5. Establish distribution planning constraints Establish distribution center layout constraints Establish inventory management constraints Establish transportation management constraints

      4.2.6. Review distribution planning policies Review distribution network Establish sourcing relationships Establish dynamic deployment policies

      4.2.7. Assess distribution planning performance Establish appropriate performance indicators (metrics) Establish monitoring frequency Calculate performance measures Identify performance trends Analyze performance benchmark gaps Prepare appropriate reports Develop performance improvement plan

      4.2.8. Develop quality standards and procedures Establish quality targets Develop standard testing procedures Communicate quality specifications

    4.3. Procure materials

      4.3.1. Develop sourcing/contracting strategies Select appropriate sourcing/contracting strategy Develop procurement plan Clarify purchasing requirements Develop inventory management approach Match needs to supply capabilities Analyze organization’s spend profile Seek opportunities to improve efficiency and value Collaborate with suppliers to identify sourcing opportunities

      4.3.2. Select suppliers and develop/maintain contracts Select suppliers Certify and validate suppliers Negotiate and establish contracts Manage contracts

      4.3.3. Order materials and services Process/Review requisitions Approve requisitions Manage competitve bidding process Solicit/Track vendor quotes Create/Distribute purchase orders Expedite orders and satisfy inquiries Record receipt of goods Research/Resolve exceptions

      4.3.4. Manage suppliers Monitor/Manage supplier information Prepare/Analyze procurement and vendor performance Support inventory and production processes Monitor quality of product delivered

    4.4. Manage logistics and warehousing

      4.4.1. Define logistics strategy Translate internal customer service requirements into logistics requirements Design logistics network Communicate outsourcing needs Develop and maintain delivery service policy Optimize transportation schedules and costs Define key performance measures

      4.4.2. Plan and manage inbound material flow Plan inbound material receipts Manage inbound material flow Monitor inbound delivery performance Manage flow of returned products

      4.4.3. Operate warehousing and PAR inventories Track inventory deployment Receive, inspect, and store inbound deliveries Track product availability Pick, pack, and ship product for delivery Track inventory accuracy Track third-party logistics storage and shipping performance

      4.4.4. Operate outbound transportation Plan, transport, and deliver outbound product Track carrier delivery performance Manage transportation fleet Process and audit carrier invoices and documents

      4.4.5. Manage returns; manage reverse logistics Authorize and process returns Perform reverse logistics Perform salvage activities Manage and process warranty claims

    4.5. Manage medical documentation

      4.5.1. Update medical records

      4.5.2. Review completeness of medical records

      4.5.3. Submit and respond to information queries

    4.6. Receive the patient for care

      4.6.1. Schedule the patient Create or update the medical record

 Collect or validate the patient's demographics

 Collect or validate the patient's insurance Solicit the referral source from the Patient Schedule the patient's requested care Remind patient of scheduled appointment Pre-register the patient in the system

      4.6.2. Verify insurance Verify the patient's insurance benefits and obtain authorization for procedure Communicate the benefits and pre-authorization status to patient Provide Financial Counseling to the Patient Provide State & Local Government Program Qualification options to the Patient Provide Charity Care options to the Patient

      4.6.3. Register the patient Collect the co-pay Collect signed medical and administrative documents Notify caretakers of the patient arrival

    4.7. Deliver care to patient

      4.7.1. Perform the initial intake Confirm identification of patient Triage patient Perform the history and physical Identify current medication Perform physical assessment

 Assess the patients vitals

 Prepare the patient for main care delivery

      4.7.2. Manage throughput and schedule resources

      4.7.3. Perform testing Order diagnostic tests Perform the diagnostic test

 Create the order requisition

 Collect or scan the patient's specimen

 Transport the patient's test specimen and requisition(s) to the ancillary clinical test service

 Conduct specimen test

 Results/Reports are sent to the ordering physician

 Analyze the test results

      4.7.4. Determine care plan Diagnose patient per test results Determine treatment type and routine Write the treatment orders Determine monitoring and ongoing test plan Continuously monitor health status and adjust care plan

      4.7.5. Execute care plan Administer ordered medication

 Reconcile medication

 Provide to patient for consumption

      4.7.6. Perform ordered procedures

      4.7.7. Engage care coordinators

    4.8. Discharge patient from care

      4.8.1. Provide patient with discharge instructions, care education, and orders Generate discharge instructions Provide discharge instructions to patient Provide providers orders to patient

      4.8.2. Solicit discharge paper signature from patient

      4.8.3. Coordinate post-discharge services Engage social case workers Schedule follow-up appointments

      4.8.4. Release patient

    4.9. Initiate follow-up communication with patient

5. Manage Customer Service (patients, employers, payors and other)

    5.1. Develop customer service strategy

      5.1.1. Develop customer service segmentation/prioritization (e.g., tiers) Analyze existing customers Analyze feedback of customer needs

      5.1.2. Define customer service policies and procedures

      5.1.3. Establish service levels for customers

    5.2. Manage patient care outreach programs

      5.2.1. Develop and implement patient care outreach programs

      5.2.2. Monitor and evaluate outcomes of patient care outreach programs

      5.2.3. Cycle outcome results into design of patient care outreach programs

      5.2.4. Monitor participation and compliance with patient care outreach programs

    5.3. Plan and manage customer service operations

      5.3.1. Plan and manage customer service work force Forecast volume of customer service contacts Schedule customer service work force Track work force utilization Monitor and evaluate quality of customer interactions with customer service representatives

      5.3.2. Manage customer service requests/inquiries Receive customer requests/inquiries Route customer requests/inquiries Respond to customer requests/inquiries

      5.3.3. Manage customer complaints Receive customer complaints Route customer complaints Resolve customer complaints Respond to customer complaints

    5.4. Measure and evaluate customer service operations

      5.4.1. Measure customer satisfaction with customer requests/inquiries handling Gather and solicit customer feedback on requests and inquiries Analyze customer request/inquiry satisfaction data and identify improvement opportunities Provide customer feedback to billing and operational call center managers

      5.4.2. Measure customer satisfaction with customer-complaint handling and resolution Solicit customer feedback on complaint handling and resolution Analyze customer complaint data and identify improvement opportunities

      5.4.3. Measure patient satisfaction with services Gather and solicitpatient feedback on services Solicit patient feedback on pre- and post- care communication effectiveness Analyze satisfaction data and identify improvement opportunities Provide patient feedback to individual departments and providers for their services

6. Develop and Manage Human Capital

    6.1. Develop and manage human resources (HR) planning, policies, and strategies

      6.1.1. Develop human resources strategy Identify strategic HR needs Define HR and business function roles and accountability Determine HR costs Establish HR measures Communicate HR strategies Develop strategy for HR systems/technologies/tools

      6.1.2. Develop and implement workforce strategy and policies Gather skill requirements according to corporate strategy and market environment Plan employee resourcing requirements per unit/organization Develop compensation plan Develop succession plan Develop employee diversity plan Develop other HR programs Develop HR policies Administer HR policies Plan employee benefits Develop work force strategy models

      6.1.3. Monitor and update strategy, plans, and policies Measure realization of objectives Measure contribution to business strategy Communicate plans and provide updates to stakeholders Review and revise HR plans

      6.1.4. Develop competency management models

    6.2. Recruit, source, and select employees

      6.2.1. Manage employee requisitions Align staffing plan to work force plan and business unit strategies/resource needs Develop and open job requisitions Develop job descriptions Post requisitions Manage internal/external job posting Web sites Modify requisitions Notify hiring manager Manage requisition dates

      6.2.2. Recruit/Source candidates Determine recruitment methods and channels Perform recruiting activities/events Manage recruitment vendors Manage employee referral programs Manage recruitment channels

      6.2.3. Screen and select candidates Identify and deploy candidate selection tools Interview candidates Test candidates Obtain candidate background information

 Validate candidates medical practice certification Select and reject candidates

      6.2.4. Manage new hire/re-hire Draw up and make offer Negotiate offer Hire candidate

      6.2.5. Manage Applicant Information Create applicant record Manage/Track applicant data Archive and retain records of non-hires

    6.3. Develop and counsel employees

      6.3.1. Manage employee orientation and deployment Create/Maintain employee on-boarding program Evaluate the effectiveness of employee on-boarding program Execute on boarding program

      6.3.2. Manage employee performance Define performance objectives Review, appraise, and manage employee performance Evaluate and review performance program

      6.3.3. Manage employee development Define employee development guidelines Develop employee career plans Manage employee skills development Track continuing medical education credits

      6.3.4. Develop and train employees Align employee and organization development needs Align learning programs with competencies Establish training needs by analysis of required and available skills Develop, conduct, and manage employee and/or management training programs

      6.3.5. Estimate workload

      6.3.6. Schedule labor

      6.3.7. Approve overtime

    6.4. Manage healthcare provider workforce

      6.4.1. Monitor and adjust labor level

    6.5. Manage employee relations

      6.5.1. Manage labor relations

      6.5.2. Manage collective bargaining process

      6.5.3. Manage labor management partnerships

      6.5.4. Manage employee grievances

    6.6. Reward and retain employees

      6.6.1. Develop and manage reward, recognition, and motivation programs Develop salary/compensation structure and plan Develop benefits and reward plan Perform competitive analysis of benefit and rewards Identify compensation requirements based on financial, benefits, and HR policies Administer compensation and rewards to employees Reward and motivate employees Deliver programs to support Work/Life balance for employees

      6.6.2. Manage and administer benefits Deliver employee benefits program Administer benefit enrollment Process claims Perform benefit reconciliation

      6.6.3. Manage employee assistance and retention

      6.6.4. Administer payroll

    6.7. Redeploy and retire employees

      6.7.1. Manage promotion and demotion process

      6.7.2. Manage separation

      6.7.3. Manage retirement

      6.7.4. Manage leave of absence

      6.7.5. Develop and implement employee outplacement

      6.7.6. Manage deployment of personnel

      6.7.7. Relocate employees, and manage assignments Manage expatriates

    6.8. Manage employee information and analytics

      6.8.1. Manage reporting processes

      6.8.2. Manage employee inquiry process

      6.8.3. Manage and maintain employee data

      6.8.4. Manage human resource information systems (HRIS)

      6.8.5. Develop and manage employee metrics

      6.8.6. Develop and manage time and attendance systems

      6.8.7. Review retention and motivation indicators

      6.8.8. Manage/Collect employee suggestions and perform employee research

    6.9. Manage employee communication

      6.9.1. Develop employee communication plan

      6.9.2. Deliver employee communications

7. Manage Information Technology

    7.1. Manage the business of information technology

      7.1.1. Develop the enterprise IT strategy Build strategic intelligence Identify long-term IT needs of the enterprise in collaboration with stakeholders Define strategic standards, guidelines, and principles Define and establish IT architecture and development standards Define strategic vendors for IT components Establish IT governance organization and processes Build strategic plan to support business objectives

      7.1.2. Define the enterprise architecture Establish the enterprise architecture definition Confirm enterprise architecture maintenance approach Maintain the relevance of the enterprise architecture Act as clearinghouse for IT research and innovation Govern the enterprise architecture

      7.1.3. Manage the IT portfolio Establish the IT portfolio Analyze and evaluate the value of the IT portfolio for the enterprise Provision resources in accordance with strategic priorities

      7.1.4. Perform IT research and innovation Research technologies to innovate IT services and solutions Transition viable technologies for IT services and solutions development

      7.1.5. Evaluate and communicate IT business value and performance Establish and monitor key performance indicators Evaluate IT plan performance Communicate IT value

    7.2. Develop and manage IT customer relationships

      7.2.1. Develop IT services and solutions strategy Research IT services and solutions to address business and user requirements Translate business and user requirements into IT services and solutions requirements Formulate IT services and solutions strategic initiatives Coordinate strategies with internal stakeholders to ensure alignment Evaluate and select IT services and solutions strategic initiatives

      7.2.2. Develop and manage IT service levels Create and maintain the IT services and solutions catalog Establish and maintain business and IT service-level agreements Evaluate and report service-level attainment results Communicate business and IT service-level improvement opportunities

      7.2.3. Perform demand-side management (DSM) for IT services Analyze IT services and solutions consumption and usage Develop and implement incentive programs that improve consumption efficiency Develop volume/unit forecast for IT services and solutions

      7.2.4. Manage IT customer satisfaction Capture and analyze customer satisfaction Assess and communicate customer satisfaction patterns Initiate improvements based on customer satisfaction patterns

      7.2.5. Market IT services and solutions Develop IT services and solutions marketing strategy Develop and manage IT customer strategy Manage IT services and solutions advertising and promotional campaigns Process and track IT services and solutions orders

    7.3. Develop and implement security, privacy, and data protection controls

      7.3.1. Establish information security, privacy, and data protection strategies and levels

      7.3.2. Test, evaluate, and implement information security and privacy and data protection controls

    7.4. Manage enterprise information

      7.4.1. Develop information and content management strategies Understand information and content management needs and the role of IT services for executing the business strategy Assess the information and content management implications of new technologies Identify and prioritize information and content management actions

      7.4.2. Define the enterprise information architecture Define information elements, composite structure, logical relationships and constraints, taxonomy, and derivation rules Define information access requirements Establish data custodianship Manage changes to content data architecture requirements

      7.4.3. Manage information resources Define the enterprise information/data policies and standards Develop and implement data and content administration

      7.4.4. Perform enterprise data and content management Define sources and destinations of content data Manage technical interfaces to users of content Manage retention, revision, and retirement of enterprise information

    7.5. Develop and maintain information technology solutions

      7.5.1. Develop the IT development strategy Establish sourcing strategy for IT development Define development processes, methodologies, and tools standards Select development methodologies and tools

      7.5.2. Perform IT services and solutions life cycle planning Plan development of new requirements Plan development of feature and functionality enhancement Develop life cycle plan for IT services and solutions

      7.5.3. Develop and maintain IT services and solutions architecture Create IT services and solutions architecture Revise IT services and solutions architecture Retire IT services and solutions architecture

      7.5.4. Create IT services and solutions Understand confirmed requirements Design IT services and solutions Acquire/Develop IT service/solution components Train services and solutions resources Test IT services/solutions Confirm customer acceptance

      7.5.5. Maintain IT services and solutions Understand upkeep/enhance requirements and defect analysis Design change to existing IT service/solution Acquire/Develop changed IT service/solution component Test IT service/solution change Retire solutions and services

    7.6. Deploy information technology solutions

      7.6.1. Develop the IT deployment strategy Establish IT services and solutions change policies Define deployment process, procedures, and tools standards Select deployment methodologies and tools

      7.6.2. Plan and implement changes Plan change deployment Communicate changes to stakeholders Administer change schedule Train impacted users Distribute and install change Verify change

      7.6.3. Plan and manage releases Understand and coordinate release design and acceptance Plan release rollout Distribute and install release Verify release

    7.7. Deliver and support information technology services

      7.7.1. Develop IT services and solution delivery strategy Establish sourcing strategy for IT delivery Define delivery processes, procedures, and tools standards Select delivery methodologies and tools

      7.7.2. Develop IT support strategy Establish sourcing strategy for IT support Define IT support services

      7.7.3. Manage IT infrastructure resources Manage IT inventory and assets Manage IT resource capacity

      7.7.4. Manage IT infrastructure operations Deliver IT services and solutions Perform IT operations support services

      7.7.5. Support IT services and solutions Manage availability Manage facilities Manage backup/recovery Manage performance and capacity Manage incidents Manage problems Manage inquiries

8. Manage Financial Resources

    8.1. Perform planning and management accounting

      8.1.1. Perform planning/budgeting/forecasting Develop and maintain budget policies and procedures Prepare periodic budgets and plans Prepare periodic financial forecasts

      8.1.2. Perform cost accounting and control Perform inventory accounting Perform cost of patient referral analysis Perform service costing Perform variance analysis Report on profitability

      8.1.3. Perform cost management Determine key cost drivers Measure cost drivers Determine critical activities Manage asset resource deployment and utilization

      8.1.4. Evaluate and manage financial performance Assess patient and service profitability Evaluate new services Perform life cycle costing Optimize payor and service mix Track performance of new- patient and service strategies Prepare activity-based performance measures Manage continuous cost improvement

    8.2. Perform revenue accounting

      8.2.1. Invoice the payor(s) Maintain patient master files Capture charges Code the Patient's Account Prepare bill for the payor Rectify any billing edits Transmit the bill to the payor Resolve payor billing inquiries

      8.2.2. Process accounts receivable (AR) Establish AR policies Receive/Deposit customer payments Apply cash remittances Prepare AR reports Post AR activity to the general ledger

      8.2.3. Manage and process collections Establish policies for delinquent accounts Analyze delinquent account balances

 Follow-up with Payor(s) for those delinquent accounts greater than time periods guided by state regulation.

      8.2.4. Discuss account resolution with internal parties

      8.2.5. Process adjustments/write off balances

    8.3. Manage denials

      8.3.1. Review A/R and account aging queue

      8.3.2. Perform retrospective denial reporting

      8.3.3. Work underpayments, denials and rejections

      8.3.4. Perform re-bill and appeals

    8.4. Perform general accounting and reporting

      8.4.1. Manage policies and procedures Negotiate service-level agreements Establish accounting policies Set and enforce approval limits Establish common financial systems

      8.4.2. Perform general accounting Maintain chart of accounts Process journal entries Process allocations Process period end adjustments (e.g., accruals and currency conversions) Post and reconcile intercompany transactions Reconcile general ledger accounts Perform consolidations and process eliminations Prepare trial balance Prepare and post management adjustments

      8.4.3. Perform fixed-asset accounting Establish fixed-asset policies and procedures Maintain fixed-asset master data files Process and record fixed-asset additions and retires Process and record fixed-asset adjustments, enhancements, revaluations, and transfers Process and record fixed-asset maintenance and repair expenses Calculate and record depreciation expense Reconcile fixed-asset ledger Track fixed-assets including physical inventory Provide fixed-asset data to support tax, statutory, and regulatory reporting

      8.4.4. Perform financial reporting Prepare business unit financial statements Prepare consolidated financial statements Perform business unit reporting/review management reports Perform consolidated reporting/review of cost management reports Prepare statements for board review Produce quarterly/annual filings and shareholder reports Produce regulatory reports

    8.5. Manage fixed-asset project accounting

      8.5.1. Perform capital planning and project approval Develop capital investment policies and procedures Develop and approve capital expenditure plans and budgets Review and approve capital projects and fixed-asset acquisitions Conduct financial justification for project approval

      8.5.2. Perform capital project accounting Create project account codes Record project-related transactions Monitor and track capital projects and budget spending Close/capitalize projects Measure financial returns on completed capital projects

    8.6. Process payroll

      8.6.1. Report time Establish policies and procedures Collect and record employee time worked Analyze and report paid and unpaid leave Monitor regular, overtime, and other hours Analyze and report employee utilization

      8.6.2. Manage pay Enter employee time worked into payroll system Maintain and administer employee earnings information Maintain and administer applicable deductions Monitor changes in tax status of employees Process and distribute payments Process and distribute manual checks Process period-end adjustments Respond to employee payroll inquiries

      8.6.3. Process payroll taxes Calculate and pay applicable payroll taxes Produce and distribute employee annual tax statements File regulatory payroll tax forms

    8.7. Process accounts payable and expense reimbursements

      8.7.1. Process accounts payable (AP) Verify AP pay file with purchase order vendor master file Maintain/Manage electronic commerce Audit invoices and key data in AP system Approve payments Process financial accruals and reversals Process taxes Research/Resolve exceptions Process payments Respond to AP inquiries Retain records Adjust accounting records

      8.7.2. Process expense reimbursements Establish and communicate expense reimbursement policies and approval limits Capture and report relevant tax data Approve reimbursements and advances Process reimbursements and advances Manage personal accounts

    8.8. Manage treasury operations

      8.8.1. Manage treasury policies and procedures Establish scope and governance of treasury operations Establish and publish treasury policies Develop treasury procedures Monitor treasury procedures Audit treasury procedures Revise treasury procedures Develop and confirm internal controls for treasury Define system security requirements

      8.8.2. Manage cash Manage and reconcile cash positions Manage cash equivalents Process and oversee electronic fund transfers (EFTs) Develop cash flow forecasts Manage cash flows Produce cash management accounting transactions and reports Manage and oversee banking relationships Analyze, negotiate, resolve, and confirm bank fees

      8.8.3. Manage in-house bank accounts Manage in-house bank accounts for subsidiaries Manage and facilitate inter-company borrowing transactions Manage centralized outgoing payments on behalf of subsidiaries Manage central incoming payments on behalf of subsidiaries Manage internal payments and netting transactions Calculate interest and fees for in-house bank accounts Provide account statements for in-house bank accounts

      8.8.4. Manage debt and investment Manage financial intermediary relationships Manage liquidity Manage issuer exposure Process and oversee debt and investment transactions Process and oversee foreign currency transactions Produce debt and investment accounting transaction reports Process and oversee interest rate transactions

      8.8.5. Monitor and execute risk and hedging transactions Manage interest-rate risk Manage foreign-exchange risk Manage exposure risk Develop and execute hedging transactions Evaluate and refine hedging positions Produce hedge accounting transactions and reports Monitor credit

    8.9. Manage internal controls

      8.9.1. Establish internal controls, policies, and procedures Establish board of directors and audit committee Define and communicate code of ethics Assign roles and responsibility for internal controls Define business process objectives and risks Define entity/unit risk tolerances

      8.9.2. Operate controls and monitor compliance with internal controls policies and procedures Design and implement control activities Monitor control effectiveness Remediate control deficiencies Create compliance function Operate compliance function Implement and maintain controls-related enabling technologies and tools

      8.9.3. Report on internal controls compliance Report to external auditors Report to regulators, share-/debt-holders, securities exchanges, etc. Report to third parties (e.g., business partners) Report to internal management

    8.10. Manage taxes

      8.10.1. Develop tax strategy and plan Develop foreign, national, state, and local tax strategy Consolidate and optimize total tax plan Maintain tax master data

      8.10.2. Process taxes Perform tax planning/strategy Prepare returns Prepare foreign taxes Calculate deferred taxes Account for taxes Monitor tax compliance Address tax inquiries

      8.10.3. Define pricing strategy to align to value proposition Establish guidelines for applying pricing of services Approve pricing strategies/policies Negotiate pricing with Healthcare Payors

      8.10.4. Develop and manage pricing Determine pricing based on volume/unit forecast, government mandate, and commercial negotations Execute pricing plan Evaluate pricing performance Refine pricing as needed

9. Acquire, Construct and Manage Assets

    9.1. Design and construct/acquire nonproductive assets

      9.1.1. Develop property strategy and long-term vision Confirm alignment of property requirements with business strategy Assess the external environment Make build, buy, or lease decision Execute build, buy, or lease transaction

      9.1.2. Develop, construct, and modify sites

      9.1.3. Plan facility Design facility Analyze budget Select property Negotiate terms for facility Manage construction or modification to building

      9.1.4. Provide workspace and assets Acquire workspace and assets Change fit/form/function of workspace and assets

    9.2. Plan maintenance work

      9.2.1. Perform routine maintenance

      9.2.2. Perform corrective maintenance

      9.2.3. Overhaul equipment

      9.2.4. Manage facilities operations Relocate people Relocate material and tools

    9.3. Obtain and install assets, equipment, and tools

      9.3.1. Develop ongoing maintenance policies for productive assets Analyze assets, and predict maintenance requirements Develop approach to integrate preventive maintenance into production schedule

      9.3.2. Tag assets, equipment, and tools

      9.3.3. Obtain and install assets, equipment, and tools Design engineering solution for the manufacturing process Install and commission equipment

    9.4. Dispose of productive and nonproductive assets

      9.4.1. Develop exit strategy

      9.4.2. Perform sale or trade

      9.4.3. Perform abandonment

    9.5. Manage real estate and space

10. Manage Enterprise Risk, Compliance, Remediation and Resiliency

    10.1. Manage enterprise risk

      10.1.1. Establish the enterprise risk framework and policies Research risk policies from an outside legal perspective Determine risk tolerance for organization Develop and maintain enterprise risk policies and procedures Identify and implement enterprise risk management tools Coordinate the sharing of risk knowledge across the organization Prepare and report enterprise risk to executive management and board

      10.1.2. Oversee and coordinate enterprise risk management activities Identify enterprise level risks Assess risks to determine which to mitigate Develop risk mitigation and management strategy, and integrate with existing performance management processes Verify business unit and functional risk mitigation plans are implemented Ensure risks and risk mitigation actions are monitored Report on risk activities

      10.1.3. Coordinate business unit and functional risk management activities Ensure that each business unit / function follows the enterprise risk management process Ensure that each business unit/function follows the enterprise risk reporting process

      10.1.4. Manage business unit and function risk Identify risks Assess risks using enterprise risk framework policies and procedures Develop mitigation plans for risks Implement mitigation plans for risks Monitor risks Analyze risk activities and update plans Report on risk activities

    10.2. Manage compliance

      10.2.1. Establish compliance framework and policies Develop enterprise compliance policies and procedures Implement enterprise compliance activities Manage internal audits Maintain controls-related technologies and tools

      10.2.2. Determine anticipated compliance to materials policies

      10.2.3. Manage regulatory compliance Develop regulatory compliance procedures Identify applicable regulatory requirements Monitor the regulatory environment for changing or emerging regulations Assess current compliance position, and identify weaknesses or shortfalls therein Implement missing or stronger regulatory compliance controls and policies Monitor and test, on an ongoing and scheduled basis, regulatory compliance position and existing controls, defining controls that should be added, removed, or modified as required Maintain relationships with regulators as appropriate

    10.3. Manage remediation efforts

      10.3.1. Monitor medical staff compliance

      10.3.2. Create remediation plans

      10.3.3. Contact and confer with experts

      10.3.4. Identify/dedicate resources

      10.3.5. Investigate legal aspects

      10.3.6. Investigate damage cause

      10.3.7. Amend or create policy

    10.4. Manage business resiliency

      10.4.1. Develop the business resilience strategy

      10.4.2. Perform continuous business operations planning

      10.4.3. Test continuous business operations

      10.4.4. Maintain continuous business operations

      10.4.5. Share knowledge of specific risks across other parts of the organization

    10.5. Manage environmental health and safety (EHS)

      10.5.1. Determine environmental health and safety impacts Evaluate environmental impact of products, services, and operations Conduct health and safety and environmental audits

      10.5.2. Develop and execute functional EHS program Identify regulatory and stakeholder requirements Assess future risks and opportunities Create EHS policy Record and manage EHS events

      10.5.3. Train and educate functional employees Communicate EHS issues to stakeholders and provide support

      10.5.4. Monitor and manage functional EHS management program Manage EHS costs and benefits Measure and report EHS performance Implement emergency response program Implement pollution prevention program Provide employees with EHS support

11. Manage External Relationships

    11.1. Manage affiliation with university medical and fellow programs

    11.2. Build investor relationships

      11.2.1. Plan, build, and manage lender relations

      11.2.2. Plan, build, and manage analyst relations

      11.2.3. Communicate with shareholders

    11.3. Manage government and industry relationships

      11.3.1. Manage government relations

      11.3.2. Manage relations with quasi-government bodies

      11.3.3. Manage relations with trade or industry groups

      11.3.4. Manage lobby activities

      11.3.5. Validate eligibility for grant funding and manage application process

    11.4. Manage Relationship with Providers (Community and Independent)

    11.5. Manage relations with board of directors

      11.5.1. Report results

      11.5.2. Report audit findings

    11.6. Manage legal and ethical issues

      11.6.1. Create ethics policies

      11.6.2. Manage corporate governance policies

      11.6.3. Develop and perform preventive law programs

      11.6.4. Ensure compliance Plan and initiate compliance program Execute compliance program

      11.6.5. Manage outside counsel Assess problem and determine work requirements Engage/Retain outside counsel if necessary Receive strategy/budget Receive work product and manage/monitor case and work performed Process payment for legal services Track legal activity/performance

      11.6.6. Protect intellectual property Manage copyrights and patents Maintain intellectual property rights and restrictions Administer licensing terms Administer options

      11.6.7. Resolve disputes and litigations

      11.6.8. Provide legal advice/counseling

      11.6.9. Negotiate and document agreements/contracts

    11.7. Manage public relations program

      11.7.1. Manage community relations

      11.7.2. Manage media relations

      11.7.3. Promote political stability

      11.7.4. Create press releases

      11.7.5. Issue press releases

      11.7.6. Monitor vendor's service level performance

    11.8. Manage service vendors

      11.8.1. Resolve discrepancies between SLA

      11.8.2. Manage vendor payments according to services delivered

12. Develop and Manage Healthcare Capabilities

    12.1. Manage business processes

      12.1.1. Establish and maintain process management governance Define and manage governance approach Establish and maintain process tools and templates Assign and support process ownership Perform process governance activities

      12.1.2. Define and manage process frameworks Establish and maintain process framework Identify cross-functional processes

      12.1.3. Define processes Scope processes Analyze processes Map processes Publish processes

      12.1.4. Manage process performance Provide process training Support process execution Measure and report process performance

      12.1.5. Improve processes Identify and select improvement opportunities Manage improvement projects Perform continuous improvement activities

    12.2. Manage portfolio, program, and project

      12.2.1. Manage portfolio Establish portfolio strategy Define portfolio governance Monitor and control portfolio

      12.2.2. Manage programs Establish program structure and approach Manage program stakeholders and partners Manage program execution Review and report program performance

      12.2.3. Manage projects Establish project scope

 Identify project requirements and objectives

 Identify project resource requirements

 Assess culture and readiness for project management approach

 Identify appropriate project management methodologies

 Create business case and obtain funding

 Develop project measures and indicators Develop project plans

 Define roles and resources

 Identify specific IT requirements

 Create training and communication plans

 Design recognition and reward approaches

 Design and plan launch of project

 Deploy the project Execute projects

 Evaluate impact of project management (strategy and projects) on measures and outcomes

 Report the status of project

 Manage project scope

 Promote and sustain activity and involvement

 Realign and refresh project management strategy and approaches Review and report project performance Close projects

    12.3. Manage enterprise quality

      12.3.1. Review medical charts

      12.3.2. Establish quality requirements Define critical-to-quality characteristics

 Consider increased efficiency

 Consider enhanced accuracy

 Consider improved access to vital information Define preventive quality activities Develop quality controls

 Define process steps for controls (or integration points)

 Define sampling plan

 Identify measurement methods

 Define required competencies Prove capability to assess compliance with requirements Finalize quality plan

      12.3.3. Evaluate performance to requirements Test against quality plan

 Conduct test and collect data

 Record result(s)

 Determine disposition of result(s) Assess results of tests

 Assess sample significance

 Summarize result(s)

 Recommend actions

 Decide next steps

      12.3.4. Manage non-conformance Assess potential impact Determine immediate action(s) Identify root cause(s) Take corrective or preventative action Close non-conformance

      12.3.5. Implement and maintain the enterprise quality management system (EQMS) Define the quality strategy Plan and deploy the EQMS scope, targets, and goals Identify core EQMS processes, controls, and metrics Develop and document EQMS policies, procedures, standards, and measures Assess the EQMS performance Create environment and capability for EQMS improvement(s)

 Reward quality excellence

 Create and maintain quality partnerships

 Maintain talent capabilities and competencies

 Incorporate EQMS messaging into communication channels

 Assure independent EQMS management access to appropriate authority in the organization

 Transfer proven EQMS methods

    12.4. Capture and analyze data analytic program

    12.5. Manage change

      12.5.1. Plan for change Select process improvement methodology Assess readiness for change Determine stakeholders Engage/Identify champion Form design team Define scope Understand current state Define future state Conduct organizational risk analysis Assess cultural issues Establish accountability for change management Identify barriers to change Determine change enablers Identify resources and develop measures

      12.5.2. Design the change Assess connection to other initiatives Develop change management plans Develop training plan Develop communication plan Develop rewards/incentives plan Establish change adoption metrics Establish/Clarify new roles Identify budget/roles

      12.5.3. Implement change Create commitment for improvement/change Re-engineer business processes and systems Support transition to new roles or exit strategies for incumbents Monitor change

      12.5.4. Sustain improvement Monitor improved process performance Capture and reuse lessons learned from change process Take corrective action as necessary

    12.6. Develop and manage enterprise-wide knowledge management (KM) capability

      12.6.1. Develop KM strategy Develop governance model Establish central KM core group Define roles and accountability of core group versus operating units Develop funding models Identify links to key initiatives Develop core KM methodologies Assess the business's IT needs and engage IT function Develop training and communication plans Develop change management approaches Develop strategic measures and indicators

      12.6.2. Assess KM capabilities Assess maturity of existing KM initiatives Evaluate existing KM approaches Identify gaps and needs Enhance/Modify existing KM approaches Develop new KM approaches Implement new KM approaches

    12.7. Measure and benchmark

      12.7.1. Create and manage organizational performance strategy Create enterprise measurement systems model Measure process productivity Measure cost effectiveness Measure staff efficiency Measure cycle time

      12.7.2. Benchmark performance Conduct performance assessments Develop benchmarking capabilities Conduct internal process and external competitive benchmarking Conduct gap analysis to understand need for change and degree needed Establish need for change


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