Job Summary:
Reporting to the Chief Financial Office (CFO) will bring a track record of leading successful teams through growth and operational improvement. He/she will provide leadership and operational support for the Revenue Cycle function as it continues to integrate its operations, acquires and integrates new practices, expands its service offering and mature processes and procedures. The Director will have primary day-to-day responsibility for operating activities for RCM and other functions as necessary and will work closely with the CFO to develop and implement an operating strategy, monitor and manage the operations of assigned functions, and implement a culture of data-driven decision making and accountability.
Preferred Education, Skills and Experience:
- Bachelor’s degree required; MBA preferred
- Successful track record for project delivery and thought leadership
- Demonstrated aptitude actively managing people and process improvement
- Strong track record of effective communication with key stakeholders and change management
- Track record with scaling processes and policies in a large diversified network
- Demonstrated ability to understand and interpret trends to drive business performance
Essential Functions/Responsibilities (other duties may be assigned):
- Responsible for overseeing and delivery of Finance department Operations, including RCM with strong policies, processes and KPI’s.
- Strong focus on continuous process improvement, delivery of transformation initiatives and yield & cost targets. Optimized operations through strong processes and compliance to policies and regulations
- Additional RCM processes include: Cash Posting, Claims Follow up, Coding, Credentialing, Payer Relations
- Develop and deepen existing partnerships with Business Leaders, ensuring Functions and processes are well positioned and can deliver innovative nimble solutions in support of changing healthcare landscape and evolving business model needs.
- Manage performance of staff members and coordinate development, coaching, and discipline according
- Collaborate to establish, refresh and develop long term strategic plan, annual operating and capital budgets.
- Oversees and effectively manages vendor partners for delivery on operations. Lead negotiations and contract management
- Monitor, manage and create Operational metrics in conjunction with Finance, Operations along with appropriate analysis and executive-level communications, highlighting performance, costs, and effectiveness of the billing and collection’s function. Lead discussions and results analysis at Revenue Management Operating Reviews with Executive and Senior Leaders
- Continually monitor the regulatory environments to ensure that payors’ evolving reimbursement structures, documentation requirements, and other requirements are evaluated and necessary changes in policies and procedures (and systems) working in close conjunction with our compliance, and Legal teams
- Lead and serve on cross functional committees as needed. Be knowledgeable of Billing Compliance Policies. Ensure that policies and practices are in place for proper adherence.
- Ensures that revenue cycle goals including clinical A/R days, cash and bad debt are delivered.
- Responsible for coordinating and enhancing the development of data collection, analysis, and reporting processes for management of the revenue cycle, including information integrity validation and interpretation.
- Serves as the financial interface and expert between the billing, IT, and clinical teams.
- Leads monthly Revenue Cycle Steering Committee Meetings, participates in revenue cycle, denial management, charge master and access management meetings.
- Ensures compliance with relevant regulations, standards and directives from regulatory agencies and third-party payers.
Physical Requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties. While performing the duties of this job, the employee is regularly required to sit, talk, hear, and use hands to write, type or operate office equipment. The employee is occasionally required to reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl; and smell. The employee is required to perform repetitive motions, including reaching above the head, and typing. The employee must occasionally lift up to 50 pounds and/or carry objects weighing up to 25 pounds. Specific vision abilities required by this job include peripheral vision, depth perception, and ability to adjust focus.
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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)