Career Paths: Focus on eligibility work becomes career keystone

Networking, CM expertise important

You don’t always know which experiences might prove beneficial when it comes to building a successful career in access services.

Although Patti Daniel, MS, CCM, LPC, LMSW/AP, never planned or expected to become the director of admissions at a 1,000-bed regional medical center, expertise gleaned from several positions early in her career serendipitously laid the perfect groundwork for the job.

Just out of college with a degree in social work and rehabilitation, Daniel says, she used an employment agency to get a job in the claims department of a Dallas insurance company. "I had never lived in Dallas before and didn’t have a network built up [to find a position in the social work field]," she explains.

Networking skills established early

Skills she acquired during the six months she worked for the insurance company, Daniel adds, served her well in all her subsequent positions, including the access director job. Her knack for network building was initially fostered when she accepted a job at Dallas County Human Services, an agency that provided temporary emergency assistance. She discovered this opportunity through the recommendation of the church pastor while serving as a volunteer church youth counselor.

"They didn’t have a social work position, but there was a secretary job open, so I took it," she notes. Within six months, Daniel had become a field social worker, making home visits and helping to meet families’ basic needs.

"One of our goals was to get the person off the Dallas County tax rolls and put them onto a permanent benefit program, if eligible," Daniel says. "There was no training at all other than how to give a food voucher."

On her own initiative, she says, Daniel went to every agency that might provide funding or resources for her clients and "learned everything about them." That knowledge — of programs such as Medicaid, Medicare, Social Security and SSI (Supplemental Security Income), Kidney Health, Crime Victims Assistance, and others — has proved invaluable in every subsequent job she has held, Daniel notes.

When clients needed an advocate, she often represented them in place of an attorney, she says, arguing before an administrative law judge at disability hearings.

Daniel was rewarded for her proactive approach, she adds wryly, by getting "all the really hard assignments." She was given the job of emergency social worker, where she responded to calls such as those in which an elderly person had been evicted, with his or her belongings on the curb.

"Within the day, I had to find a place to move them to, find someone to move them, and get utilities and food set up," Daniel says. "I couldn’t do that without networking, so I started building a network early in my career, and learned how valuable they were."

During her tenure with the temporary assistance agency, Daniel adds, she became its unofficial training coordinator, bringing in speakers to talk with staff about eligibility programs. After five years, she became the supervisor, overseeing employees who made the home visits.

"I learned not only the benefit programs, but a lot of medical information," Daniel notes, "like how long a person would be disabled because of certain conditions — whether six or eight weeks with a broken leg, or with something more serious for a lifetime. I had to know which program would be right for each person. That knowledge has been valuable throughout my career and is to this day."

Expanding on networking skills

Daniel spent the next 20 years of her career in positions associated with Parkland Health and Hospital System in Dallas, first as director of the Access Center for the Elderly, serving as "the glue that kept the providers in the aging network working together to serve the needs of the elderly."

Again, she drew from, and expanded on, her expertise in networking and benefits programs, Daniel explains. "The network I coordinated represented 55 public and private health and human services agencies," she adds. "It was a case management program where, on a weekly basis, we would discuss the programs and talk about getting [people’s] needs met."

Daniel’s next job in the health care system was as a program director for Out of County Case Management where the focus on eligibility took a different twist, she notes. That program’s goal was to identify patients who were not county residents, and therefore not eligible for charity care through the Dallas district, and to then find funding sources for them.

"I was in the same mode I had been in — trying to develop benefits. But these were health care benefits that could get hospital bills paid for these out-of-county patients, who represented between 5% and 10% of the patient population," she explains. "I was able to do that through some of the same programs I had been working with. My goal was to get the bills paid and find a place to refer the patients in their own county where they could receive future medical care."

As she developed the program, Daniel says, she educated hospital staff so they would know how to manage the needs of these patients, integrating the information into the financial registration practice of the hospital.

"I realized the key to making this work was hiring registration staff that would register only out-of-county patients," she adds.

Expertise leads to advancements

As program director, she supervised social workers and nurses, Daniel notes, and eventually also had registration staff reporting to her. "I recognized that out-of-county patients were being registered inaccurately across the system, and weren’t being asked to meet their financial responsibility in advance in nonemergent cases."

After five years of directing the out-of-county program, which was under the umbrella of the hospital’s patient services department, Daniel was promoted to director of patient services. At this time she took on oversight for social work, home care, interpreters, and drug and alcohol services.

Two years later, she says, the position of admissions and registration director became available, and the hospital’s chief financial officer — someone who, interestingly, she had first worked with when he was the accountant at the Access Center for the Elderly, offered her that job.

"He asked me to serve, knowing I had networked with social work, nursing, and medical personnel across the system already," Daniel points out. "He knew I had the leadership and people skills needed to run the department."

Daniel recently left that position and now is the associate vice president of a private company in the field of third-party eligibility where, again, her eligibility expertise is important.

Over the course of her career, she has served on more than 20 Health and Human Services advisory boards. At present, she is a member of the board of the Washington, DC-based National Association of Healthcare Access Management, serving as chairman of the government relations and public policy committee.

The third hallmark of Daniel’s career, in addition to networking and the continuing focus on eligibility work, is her belief in the importance of education.

"Sometimes education will open doors, show people what you’re able to achieve," she says. "When I was 26, I went back to school, realizing I would not get ahead with just a bachelor’s degree. It nearly killed me, but I got a master’s in counseling in two years."

That philosophy has influenced her own hiring decisions, adds Daniel, who says she has always sought to raise the level of expertise of those who worked under her. "I’ve hired people with master’s degrees, even if the degree is in an unrelated field. It shows the person is able to complete a long project and manage it successfully."

(Editor’s note: Patti Daniel can be reached at