Job Description

The Vice President Revenue Cycle Management (VP RCM) is responsible for ensuring the effective and cost-efficient management of billing, denial management, collections, utilization management and related support activities across the network. VP provides strategic leadership in the development and maintenance of cost-effective policies, procedures, metrics, people, and programs to improve intake quality, billing and compliance processes and collect past due receivables and reduce AR days. The VP of RCM will be directly accountable for the management and financial performance of the department.

Priorities will include streamlining process and centralizing RCM across the network. The VP of RCM will create department goals, objectives, and a tactical plan consistent with the organizational strategic plan and vision and executing against near-term plans for current billing initiatives. This will also include fine-tuning the operating activities to optimize revenue collections as well as developing key service and support metrics.

The VP must work effectively as a team member utilizing effective problem-solving skills and intradepartmental relationships. Possess the ability to motivate others to achieve the vision, while balancing the big picture with perspective to the details of the operation.

Key responsibilities include:

• Development and maintenance of policies, procedures, processes, systems metrics, people, and programs required to improve the quality and performance of end-to-end RCM processes.
• Monitor claims payment to ensure reimbursements match contracted rates. Identify reimbursement opportunities and resolve payer challenges.
• Develop and achieve the Company budget for the Revenue Cycle Management department.
• Develop, implement, maintain and produce monthly accounts receivable reports to record financial performance, measure unit productivity and manage workflows in accordance with established goals.
• Ensure the department meets month end close requirements as defined by the CFO.
• Communicate financial performance to management via required monthly reporting.
• Perform necessary review, testing, training and oversight of our EMR and billing systems to ensure the integrity of the data resulting from billing and collections processes.
• Support Company growth through participation in Business Development projects, providing departmental leadership and procuring necessary resources to ensure RCM related due diligence activities are performed as required.
• Ability to integrate acquisitions into revenue cycle operations efficiently.
• Develop transition plans and oversee the effective and timely integration of billing and collections activities related to new facilities that are added by the company.
• Assist internal and external audit function as required.
• Assures Company billing compliance initiatives are deployed and maintained per Company policy.
• Implement a communication program for operations and facility management associates that the business office supports.
• Implement appropriate staff education programs and develop training programs to ensure compliance with applicable laws, regulations, payor and requirements applicable to our business.
• Hands-on participation in process/workflow design and automation improvements to support growth.

The Candidate

Experience and Professional Qualifications

Ideally, the successful candidate will have proven experience with a Private Equity backed complex healthcare services organization with multiple locations in multiple states within a levered environment, where s/he has dealt with lenders. Understands PE ownership reporting & Analysis expectations. Prior experience with a successful exit is strongly preferred by not a requirement. The VP of RCM must be a hands-on, detailed oriented individual with strong interpersonal skills that can drive execution and accountability across the RCM landscape of the organization.

Robust experience in healthcare services is mandatory. Understanding the nuances of revenue cycle and consolidating financials across multiple facilities will be critical to the individual’s success; Conduct regular center-level P&L review sessions with the operations team.

Additional experience and professional qualifications include:

• 10 + years of progressive revenue cycle management in a healthcare environment.
• Minimum 5 + years or more healthcare management experience in multi-state environment.
• Extensive knowledge of billing, regulatory requirements, billing compliance, business operations, financial systems, and reporting.
• Excellent written and interpersonal communication skills. Ability to interface with staff and customers at various levels of knowledge and skill sets.
• Knowledge of computer software systems for collection of data, reporting mechanisms and communications.
• Leadership skills to motivate teams and achieve performance goals.
• A thorough knowledge of the revenue cycle across the organization. Displays the confidence to challenge the status quo to improve organizational effectiveness.
• Experience closing out billing systems and interfacing transaction summaries to the general ledger
• In depth, knowledge of federal and state regulations as they pertain to billing. Ensuring that the processes followed comply with all regulations.
• The ability to negotiate contract rates and lines of services as needed for the business. To ensure successful negotiated reimbursement rates data is consolidated and clearly presented.
• Requires analytical analysis of accounts receivables and the ability to summarize and support the results.
• Requires critical thinking and problem-solving skills.
• Experience as a team member and as a team leader on problem-solving projects.
• Ability to effectively lead, motivate and manage a team.
• Ability to use computer systems for both the processing and reporting on the revenue cycle.
• A high degree of analytical and research skills with and attention to detail.
• Ability to communicate effectively with all levels in the company. Proactively communicates if there are any issues that affect the Revenue Cycle department achieving their goals along with recommended solutions.
• Athena EMR implementation experience highly preferred.

Education

• Bachelor’s degree in a relevant field required.
• Advanced degree preferred.

Compensation

• The final candidate will receive a competitive and comprehensive compensation package including base salary, annual bonus, and equity.

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