Company Description
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Job Description
Reporting to the SVP, Performance & Value Based Care Operations, The VP, Operations is responsible for cross-functional leadership overseeing the execution and performance of end to end revenue cycle, credentialing, and operations functions for BASS Privia Management Company.
Primary Job Duties:
- Provides leadership and ensures accountability of the following areas: Refunds, Billing, Revenue Optimization, AR Management, Training, Unpostables, Coding and Overpayments, and Credentialing.
- Additionally lead the successful integration and operation of the Performance Management, Value-based care and Care Center Transformation, Implementation, and Training functions.
- Monitors and evaluates current reimbursement/payment rules and ensures that regulatory changes impacting medical billing are anticipated and communicated to the clinical/medical staff, and departmental billing personnel and vendors.
- Maintain and organize payor contracts and value based care arrangements to ensure compliance with contractual requirements and to maximize reimbursement.
- Provide expertise in fee for service client billing & collections, develops supporting policies and procedures, and advises and trains clinical and medical departments on federal rules and regulations.
- Provide provider training in coding and facilitate regular audits of charts to ensure proper contractual and statutory compliance.
- Work closely with the market president and leadership team on key operational issues, strategic and growth initiatives.
- Manage metrics, goals, reporting and data analytics related to revenue cycle, care center workflow, and credentialing.
- Provides advice and support to senior management regarding matters related to all aspects of revenue management.
Qualifications
- Bachelor’s degree and Healthcare Masters or MBA highly preferred.
- 10+ years of healthcare industry experience in a revenue cycle leadership role required; specifically working with physicians practices, medical groups, health systems and payors.
- Must understand the entire spectrum of Revenue Cycle Management and Credentialing; detailed understanding of billing technical elements (standard forms and data, coordination of benefit and third party liability billing and collection, electronic billing, data edit programs, and reimbursement methodologies).
- Previous experience in directly managing healthcare departments and teams required.
- Experience with population health, health plan negotiation, and value based care preferred.
- Quantitatively and financially focused must know how to read and manage a balance sheet and explain financial data.
- Experience in creating and managing departmental budgets.
- Proven track record of developing strong relationships with measurable positive outcomes.
- Advanced computer systems knowledge and technical skills including Google Suite and Excel.
- Must comply with HIPAA rules and regulations.
The salary range for this role is $200,000 to $225,000 in base pay and exclusive of any bonuses or benefits. This role is also eligible for an annual bonus and restricted stock units. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only, not applicable for onsite/in office work):
In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.
