The chance for growth within patient access gives employees a sense of loyalty and ownership. This makes it more likely they will stay in the department. “They will want to stay and grow vs. moving on to another area,” says Elkin Pinamonti, MHA, assistant director of onsite access for Novant Health’s greater Winston-Salem, NC, and northern Virginia markets.

According to Pinamonti, these are the steps that put patient access employees on the leadership track:

1. Identify high-performing team members.

2. Develop a performance plan.

“This gives the employee specific goals or benchmarks to work on that will assist in their movement to a leader role,” Pinamonti says.

3. Set a specific date to review the team member’s progress.

Leaders can use this time to discuss what the employee has accomplished.

“It’s vital that this be done consistently and doesn’t fall off the radar,” Pinamonti advises.

4. Allow high performers to be the point person on a special project.

“This allows you to see how they would do in a leadership role,” Pinamonti says.

The department recently put a registrar in charge of a collections initiative for obstetrics patients. Another registrar is working on teamwork training that will be presented for all departments across the revenue cycle division. A third registrar is identifying what to change in the hospital’s electronic medical record to streamline registration processes.

5. Use career development tools to identify a team member’s strengths.

“Then, guide them in a direction that will best suit them,” Pinamonti says.

These efforts often fall off the radar of a busy patient access leader’s schedule. However, there is a large return on investment in the form of reduced turnover.

“You are more apt to retain that team member vs. losing them to another department,” Pinamonti explains. “The team member is seeing growth opportunity.”

The department is developing a career ladder.

“Once implemented, it will assist in retention rates and help to decrease turnover,” Pinamonti reports.

Turnover often happens because there are no positions for patient access employees to move into. The new career ladder will change this at Novant Health, according to Pinamonti.

“It will allow for team members to move within the department, rather than having to move on due to lack of movement opportunities,” she says.


  • Elkin Pinamonti, MHA, Assistant Director, Onsite Access, Greater Winston-Salem, Northern Virginia Markets, Novant Health, Winston-Salem, NC. Phone: (336) 718-4935. Email: