Job Purpose
The Director, Revenue Cycle Transformation Services – Patient Financial Services will be a part of our Revenue Cycle Transformation division, which plays a pivotal role in driving the financial success of our organization and our customers. The team is responsible for leading and implementing initiatives that enhance revenue cycle performance, optimize operational efficiency, and improve financial outcomes. We are seeking a dynamic individual with expertise in revenue cycle transformation to join us in this critical role. The position demands a strong revenue cycle background and experience leading assessments and implementation initiatives within health systems and medical groups to optimize hospital billing, collections, and denial processes. The successful candidate should possess exceptional communication, critical thinking, and client relationship skills, along with a deep understanding of revenue cycle management and evolving payer requirements.
Duties & Responsibilities
- Lead and drive Patient Financial Service revenue cycle transformation initiatives to maximize efficiency and effectiveness of full end-to-end revenue cycle operations and services for clients
- Effectively manage project plans including meeting deadlines and manage on time deliverables
- Prepare comprehensive reports, presentations and documentation as required to monitor, evaluate, and communicate the effectiveness of Patient Account initiatives
- Improve tracking tools and develop KPIs and metrics (Quality, Process, Financials, and Patient Satisfaction) to identify and quantify quality and operational performance improvement opportunities
- Function as a Patient Financial Services subject matter expert addressing inquiries from clients and team members
- Collaborate with colleagues and client counterparts to understand business challenges, adapt implementation methodologies, and approaches to ensure results align with department objectives
- Monitor analytics to report progress on any detected trends in denials and procedural problems and develop recommendations regarding the execution of corrective actions
- Maintain a positive and professional demeanor with clients and team members
- Develop scalable transition plans to ensure improvements are sustainable
- Assist in development and improvement of revenue cycle assessment and implementation methodologies
- Evaluate current-state operations and create the blueprint for the organizational transition from the current state to the desired future state
- Establish realistic and measurable goals and priorities aligned with organizational objectives
- Other duties as assigned
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Understand and comply with Information Security and HIPAA policies and procedures at all times
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications
- Bachelor's degree in Business Administration, Healthcare Administration, Finance, or a related field preferred
- Proven experience in a leadership role within revenue cycle services, preferably in a healthcare hospital-based healthcare setting
- 7+ years of experience in healthcare operations related to patient accounts – billing, insurance / self-pay collections, and denial prevention
- 7+ years of healthcare consulting experience
- Proven success leading large-scale Patient Financial Services strategic development and implementations
- Professional certifications such as (CHAA) or (CHAM) or demonstrated progress toward such certifications a plus
- Advanced level of Excel proficiency and experience in financial modeling and analysis
- Advanced Microsoft PowerPoint and Word skills a must; experience with SQL, SPSS, Power BI, benchmarking, MGMA survey data a plus
- Project leadership and workplan management experience for opportunity assessments within a consulting firm setting with a focus on patient financial service revenue cycle areas
- Strong understanding of revenue cycle management principles and practices, with a demonstrated ability to deliver high-quality services to clients
- Possess knowledge of state and federal governmental, legal, and regulatory provisions related to front-end revenue cycle operations
- Exceptional communication and interpersonal skills, with the ability to effectively interact with clients, colleagues, and stakeholders at all levels in a quickly responsive and articulate manner
- Strong analytical and problem-solving abilities, with a data-driven approach to decision-making and a focus on continuous improvement
- Ability to adapt to a fast-paced and changing environment, managing multiple priorities and deadlines effectively
Working Conditions
- Occasional travel and flexibility to work outside of normal business hours as needed
- Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress
- Work Environment: The noise level in the work environment is usually minimal
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
