System Director Revenue Cycle Operations

Overview

The System Director, NAH Revenue Cycle Operations is responsible for the organization and overall management of the departmental workflows and technology optimization efforts within the Revenue Cycle; including but not limited to: Patient Access, Insurance Verification Unit, Central Business Office, the NAH Provider Medical Group, Denials Management, and any other potential entities under the purview of the Vice President of Revenue Cycle Operation. This also includes the management of the Revenue Cycle IT team, and collaboration with other ancillary department directors. The Director also provides organizational support and expertise around, primarily the technical support; but also possesses operational knowledge around processes related to throughput, workflow, labor management, optimization, and overall ancillary department structure where applicable. The Director is expected to work independently and in partnership with the VP, RCO & all Departmental Directors to better scope, strategize, prioritize, resource-broker, root-cause analyze, solve inefficiencies, identify, and define work across all campuses and business lines. The Director, Revenue Cycle Operations must be patient-centric and willing to challenge inefficiency and non-patient satisfying practices.

* This is a Remote position – “NAH reserves the right to make hiring decisions based in part on applicants’ state of residence if outside the state of Arizona”.

Responsibilities

Department Management
* Oversees all vendor partnerships; including management of performance expectations.

* Supports the Revenue Cycle departments and the RCO as it relates to organizational strategies and initiatives around: Population Health, Pathfinder Health/ACO, Community EMR, Strategic pricing, Licensure, etc.

* Provide leadership, management, coaching, and strategy expertise to the VP, RCO and key leaders within Revenue Cycle and the service line leaders.

*Cultivates and maintains strong working relationships with Revenue Cycle leadership team; helping to assure technical resources are appropriately allocated to accomplish organizational and Revenue Cycle objectives. .

* Manage and monitor KPIs for maintained improvement. .

* Review and monitor monthly/weekly reports for trends and performance. .

* Lead and mentor project teams to drive quality improvements through interdepartmental partnership. .

*Responsible for vetting and implementation of system enhancements for RCO areas.

* Proactively identifies areas for improvement within the department and collaborates with direct reports to implement comprehensive plans of action for improvement that includes consistent monitoring. .

* Builds, maintains, and enhances the Revenue Cycle relationship with IT and Informatics; helping establish the technical strategy for the organization with the Clinical Informatics team, Cerner & NAH architects, Director of IT services, CMIO, CNIO, CIO, etc. .

Financial Management
* Achieves departmental goals/objectives; namely Cash-to-goal, A/R Agings, Credit balances, DNFB and AR Days.

* Responsible for the oversight of payor credentialing functions for Northern Arizona Healthcare; including clinic practices.

* Maintains applicable NAH payer contracts and credentialing criteria. Also maintains knowledge related to hospital, clinic, ASC, and specialty provider licensure; and the corresponding impact to reimbursement and patient out-of-pocket responsibility.

* Evaluates and negotiates vendor contracts as appropriate.

* Assists VP, RCO in annual budgeting process.

* Ensures that project/department milestones and goals are met in adherence to approved budget.

* Establish, monitor and disseminate yearly KPI metrics for RCO.

People Management
* Participates in administrative staff meetings and is prepared to provide payer information updates, accounts receivable performance data, and patient financial service trends.

* Hires, provides performance assessments and feedback, and develops staff.

* Conducts timely performance reviews and provides on-going feedback. .

* Establishes and monitors individual and team goals and objectives. .

* Approves time and PTO on a weekly basis. .

* Creates opportunities to celebrate the accomplishments of staff, providers, and peers. .

* Challenges people, ideas, and opinions to develop the best possible support. .

* Provide and support the opportunity for continual education to team. .

* Ensures optimum, cost-effective staffing levels adhering to staffing guidelines and budgeted FTE’s within the areas of responsibility.

* Develops and maintains adequate and appropriately trained staff to support NAHPG coding, charge entry, billing, and collections activities; responds to patients and other customers in a manner that conveys willingness to support patients in resolving account or insurance issues.

Process Improvement
* Seeks opportunities to increase automation of work processes and optimize use of billing system functionality as well as available interfaces and collateral information systems through collaboration with Physician IT, billing vendor representatives, and other software vendors.

* Utilizes data from the billing system to identify trends in user performance that warrant attention among practice and RCM staff to both accomplishments and improvement opportunities.

* Supports and/or coordinates plans with the Director of Operations and Practice Managers to respond as needed to favorable and negative trends. Owns the oversight of the Cerner BOS partnership.

* Collaborates with Practice Operations, Finance, and outsourced and corporate service function areas to implement and evaluate operational programs, processes and initiatives pertaining to the capture and reimbursement of patient revenue.

*Create and maintain patient centric revenue cycle with efficient workflows.

*Help the organization achieve cost-cutting goals by presenting expertise and opinions of alternatives when appropriate.

*May assist the VP, RCO from a project management standpoint on key strategic initiatives.

* While reporting to the, VP, Revenue Cycle, the Director should be in consistent contact with key organizational leaders and decision makers; ensuring that appropriate understanding of strategy and decisions is known before timelines are set.

Compliance/Safety
* Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

* Stays current and complies with state and federal regulations/statutes and company policies that impact the employee’s area of responsibility.

* If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.

* Completes all company mandatory modules and required job-specific training in the specified time frame.

* Responsible for the maintenance of applicable policies and procedures that are consistent with Northern Arizona Healthcare and Northern Arizona Healthcare Physician Group, LLC, system-wide patient financial policies, and procedures.

Qualifications

Education
Bachelor’s degree- Required

Experience
Minimum of five years of experience in health care revenue cycle and/or revenue cycle IT management with operational knowledge of provider billing and coding, claims process, insurance, patient access and self pay follow up – Required
Minimum of three (3) years experience working with public and private health care payers and reimbursement.- Required
Previous experience in business process redesign and change management.- Required
5 years of progressive experience in healthcare IT- Preferred

Certification & Licensures
CPC- Preferred