Director Revenue Cycle

This position is responsible for setting the strategic direction of Revenue Cycle including Patient Access, Health Information Management, Clinical Documentation Improvement, Compliance, Billing, Charge Master and Denial Management across CCAD and reviewing and developing processes and systems to improve financial performance and generate cash flow. The Revenue Cycle includes: Patient Access, Contact Center, Clinical Documentation Improvement, HIMS Coding/Operations and Patient Financial Services as it relates to billing, coding and regulatory compliance, denials, audit and compliance. This position is also responsible for providing overall decision support, organizational planning and operational leadership and will proactively identify, develop, and execute critical process improvement initiatives to drive best practice performance and favorably impact accounts receivables, cash acceleration and net revenue across CCAD.

PRIMARY JOB DUTIES AND RESPONSIBILITIES:

1. Develops and directs the implementation of business planning policy, procedures and tracking.
2. Defines, in collaboration with other members of the Finance team, the overall revenue cycle strategy for CCAD.
3. Provides necessary governance with optimal integration and operational control of Revenue Cycle functions in the areas of Patient Access, Contact Center, Clinical Documentation Improvement, Health Information Management, Coding, Patient Financial Services, Audit and Compliance systems in an effort to optimize revenue cycle performance.
4. Develop, redesign, and monitor new KPI's for presentation and review by Senior Leadership including payer mix, accounts receivable, collection rates, adjustments, bad debt write off, estimated collections, appeal success rates, denials and other requested parameters.
5. Works to enhance and develop the revenue cycle centralization across CCAD.
6. Effectively communicates with the diverse constituents of revenue cycle to ensure that revenue cycle is meeting the expectations of its many customers.
7. Develops and promotes an environment of service excellence, collaboration and patient-centric performance throughout CCAD.
8. Acts as an internal consultant in the development of financial business plans within the Institutes.
9. Develops and maintains internal controls to target revenue recovery throughout the organization by identifying charge capture, coding, and reimbursement problems then recommending/implementing solutions.
10. Develops processes and systems to improve financial performance and cash flow.
11. Monitors A/R effectively and ensures aging categories are within established goals and national benchmarks.
12. Ensures DNFB remains within established goals.
13. Leads project management support for all projects utilizing long range plan models.
14. Supports corporate compliance initiatives by ensuring the development and implementation of appropriate policies and procedures as it relates to Revenue Cycle.
15. Oversees staff to ensure timelines are met in regard to the effectiveness, correction of, and policing of late charges.
16. Develops and oversees strategic financial planning analysis activities.
17. Manages staff to effectively meet goals and objectives and ensures staff is educated on new technology, goals and contracts.
18. Proposes and analyzes new technology and processes to maximize efficiency and accuracy in the revenue cycle processes.
19. Works with Payer Contracting to identify any payer relation issues or contracts that need to be renegotiated or negotiated for the first time.
20. Works with the Clinical Leaders across the organization to ensure documentation, coding, charge capture aligns with the budget reviews for all the Institutes.
21. Works with Daman and the Department of Health to enhance processes to ensure clinical documentation and justification by physicians are recognized especially when new procedures such as transplants, robotic surgeries, cardiac surgeries are introduced to CCAD to ensure appropriate reimbursement to CCAD.
22. Provides and analyzes reports to the Chief Financial Officer by using technology to deliver accurate reporting of Revenue cycle metrics to improve processes and workflow.
23. Works with CCF and other Mubadala Health Care assets to assist and share best practices across Revenue Cycle.
24. Performs other duties as assigned.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

Typical physical demands include: a high degree of manual dexterity to sufficiently perform computer functions on a keyboard, produce materials on a PC and operate basic office equipment, normal or corrected vision and hearing, operate audiovisual equipment used during training programs, physically move, lift and carry training equipment and materials, mobility sufficient to visit with departments or employees throughout CCAD, stand in front of an audience for up to eight (8) hours a day and lift up to 30 lbs.

ORGANIZATION-WIDE COMPETENCY ASSESSMENT REQUIREMENTS:

All employees will embrace the CCAD mission, vision and values and be responsible for adhering to the core values of the institution, including: Patient's First, Collaboration, Mutual Respect, Quality, Patient Safety, Integrity, Cultural Sensitivity and Compassion.

All employees are also expected to meet the standards of performance outlined in the Organization-Wide Competencies listed below as applied to the position.

Customer Service Orientation includes attitude, behavior, interpersonal skill and problem solving that enable an employee to respond to internal and external customer needs and expectations in a positive manner. Adaptability including teamwork, flexibility needed to fulfill job responsibilities, adapting to changes in work environment and accepting supervisory feedback. Efficiency and Effectiveness includes quantity and quality of desired work, as well as organization skills necessary to perform successfully. Essential Job Requirements includes adherence to all relevant policies, procedures and guidelines affecting the work environment, as well as maintenance of required competencies and communication skills. Managerial Responsibilities includes overall accountability for assigned work group relative to operational goals, personnel requirements and budgetary constraints.

Assume responsibility of own safety and health and will abide by CCAD Occupational Health and Safety policies and procedures as per OSHAD and any other relevant requirements.

QUALIFICATION & EXPERIENCE REQUIREMENTS

ESSENTIAL: Bachelor's degree in Business Administration, Health Administration or related field, is required.

PREFERRED: Master's degree in Finance or Business Administration, or related field, is required.

Experience

Minimum of fifteen (15) years finance experience, preferably in a health care environment, is required.

Knowledge and understanding of healthcare revenue cycle management and managing staff of professionals in the revenue cycle environment.

Job Specific Skills and Abilities

Proficient in the use of PCs, spreadsheets and other databases.

Strong analytical skills.

Strong oral and written communication skills.

Proficiency with Microsoft Office suite.

Fluency in written and spoken English.

Understanding of Business/ Hospital Policies & Procedures- Expert.

Data Reliability and Validity- Expert.

Work in Interdisciplinary Teams.

Practice-Based Learning & Improvement- Expert.