Director of Revenue Cycle – Performance Integrity, Denials Prevention

Overview The Director of Revenue Cycle provides leadership and accountability for operational excellence of one or more of the major functions within Revenue Cycle.

The Director of Revenue Cycle will implement effective strategies that ensures department and organization achieves goals as well as to provide excellent customer experience, both internal and external, and help assure the overall health of the revenue cycle and its major front, mid and back end functions.

shared services which consist of (reporting and analytics, system analysis, performance improvement, and automation)
service.

This position provides overall operational support for the entire department, oversight of assigned Revenue Cycle functions and execution on daily requirements as well as strategic programs and priorities to achieve leading practice performance and primary contributor to strong financial health of the organization
Director serves as a subject matter expert / technical competence and accountable leader for enterprise standardization and optimization of domain leading in world class performance in collaboration with team and partnerships.

The role will lead in governance forums as well as act in designated liaison roles with partners and stakeholders to ensure comprehensive awareness, alignment, decision making, policy, metric transparency and performance that results in compliant and trusted outcomes for patients, providers, workforce and system.

Overall responsibilities include development and oversight of operational metrics, people, plans and programs including financial, systems/processes and internal controls for assigned Revenue Cycle functions In addition, this position ensures that the assigned Revenue Cycle functions actively engage in continuous process improvement to enhance performance and create efficiencies.

Continuous process improvement that supports exceptional patient/ family experience related to quality access, communication in the patient’s financial journey.

Focus on quality, consistency, simplified, convenient and personalized service that compliments the patient’s care.

Understands, advocates (consumerism) and promotes transparency and informed decision making in compliance with industry standards and on behalf of the patient /patient’s financial rights.

Ultimately responsible for compliance and quality standards for assigned Revenue Cycle functions.

Responsibilities
Provides Strategic Direction.

Performs continuous assessment to help identify strengths, weaknesses, opportunities, and threats to revenue cycle functions.

Identifies, evaluates, develops, and implements strategies and tactics to achieve organizational objectives.

Oversees functions, priorities and staff effectiveness to ensure maximum outcomes are achieved and work is executed in a compliant, accurate and timely manner.

Manages Staff.

Helps develop organizational structure and job descriptions to optimize staffing resources.

Hires, orients, and trains management staff.

Assures development and implementation of key productivity and quality standards for department processes.

Evaluates staff performance and provides feedback, coaching, and correct action when necessary.

Ensures appropriate staff education and training programs are in place.

Identifies opportunities and works with staff to implement plans to improve staff engagement.

Performs succession planning to provide development opportunities for key staff identified for future roles within the organization.

Understands and follows human resource policies and procedures.

Oversees the activities of outsourced/external vendors including implementation and on-going performance.

Represents Revenue Cycle and Fairview Health Services at industry forums to network and identify process improvement opportunities.

Provides oversight to ensure compliance with established laws, regulations, practices, and procedures.

Monitors Finances.

Develops and monitors budgets for assigned areas.

Ensures key performance indicators are monitored and being
Identifies, evaluates, and implements, as appropriate, cost reduction opportunities Meets budget expectations.

Develops Strong Working Relationships.

Leads or participates in work with peers and other departments to create an excellent understanding of workflows and interdependencies, and to identify and implement strategies to improve revenue cycle performance.

Responsible for developing and mentoring leaders within areas.

Establishes performance standards, identification of goals and outcomes.

Drives employee selection and ensures employees are orientated to the organization, business unit and position.

Develops and manages financial forecasts for entity.

Along with senior management team, accountable for closing gap between run rate and target.

Plans, directs, and oversees annual budget development and ongoing management for all areas of responsibility.

Manages capital project budgets.

Fosters a culture of improvement, efficiency, and innovative thinking.

Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards.

Creates structures and processes within team and internal customers to continuously optimize and improve processes to mitigate denials and write-offs and improve transparency of the patient’s financial journey.

Continuous implementation of strategies and tactics ensuring metrics align with benchmark standards.

Establishes and works with leadership team to monitor, manage, and take action as appropriate related to productivity and quality as well as creating efficiency leveraging technology to achieve leading practice performance.

Establishes, maintains, and ensures appropriate education vehicles for team and customers remaining current with regulations and payer requirements.

Creates and cultivates culture of analysis, trends, issues, risk and resolution tracking with team and customers to identify patterns and appropriate solutions in a timely manner
Establishes department metrics and KPI’s for department to monitor and measure performance and associated strategy and tactics that result in leading practice benchmarks
Performs other responsibilities as needed/assigned.

Qualifications