Position Description:
In collaboration with Rush University System for Health (“Rush”) senior leadership team, the Senior Vice President (“SVP”) provides strategic direction and oversight of revenue cycle operations across the health system. The SVP will report to the Chief Financial Officer and be the lead executive to effectively collaborate and communicate with the medical center executives on Revenue Cycle operations. The scope of the role includes overall leadership for the revenue cycle, overseeing functions across the medical center. The SVP will have direct management responsibility for the following functions across the medical center: Hospital Registration/Check-in, Pre-Registration, Patient Estimates, Insurance Verification, Pre-authorization Verification, Financial Counseling, Coding, HIM, Billing, Follow-up Collections, Revenue Integrity, Cash Posting, Correspondence, Refunds, Self-Pay, Customer Service, Bad Debt, Revenue Cycle Training, Revenue Cycle Systems, Data Analytics, and Reporting, Denial Prevention, Vendor Management, Compliance, and Policy & Procedures.
High-level Key Accountabilities:
Strategy
• Develops long-range strategic plans for systems and processes that support the collective aspirational goals as outlined above.
• Leads the implementation of strategic and operational plans for assigned functions that addresses operations, financial performance, customer service, IT, human capital and regulatory requirements.
• Ensures the overall revenue cycle strategy aligns with/supports business objectives and is focused enterprise-wide to maximize cash collections and to decrease the cost to collect.
• Leads the effort to build revenue cycle business literacy across the organization. Builds effective, collaborative relationships with key stakeholders across departments (e.g., IT, Human Performance, Finance, and clinical departments)
• Collaborates with financial and information technology contributors to develop and operationalize a transformation roadmap.
• Advises on the charging strategy and charging standardization.
Leadership
• Provides leadership and supports governance processes to result in effective, efficient, standardized, and compliant practices across the medical center.
• Organizes routine educational “in services” including regular meetings to support effective operations and the sharing of best practices.
• Is a champion of associate engagement initiatives that aligns with the medical center culture and values.
• Creates strategies to improve the associate experience at the medical center.
• Collaborates with leaders overseeing Contract Center, Case Management, Utilization Review, and CDI to develop streamline processes and clear roles and responsibilities to improve organizational outcomes.
Revenue Cycle Project/Program Management
• Provides leadership oversight for new market growth, system implementations, conversions, and upgrades for revenue cycle applications.
• Investigates and resolves complex problems and coordinates efforts to provide innovative strategies and solutions.
• Assesses new technology, performs vendor assessments, creates ROI analyses, and recommends new technology.
• Establishes and maintains strong working relationships with Revenue Cycle leaders, key stakeholders, and fosters a strong working relationship with key strategic partners.
• Maintains strong understanding of revenue cycle metrics and leads team in building plans to support operational departments to achieve best practice performance through strong analytical capabilities, process improvement identification, and technology enhancements.
• Maintains strong understanding of health information system functionality and leads team in identifying and implementing functionality that improves revenue cycle performance, streamlines workflow, and reduces cost-to-collect.
Process Design/Implementation/Operations/Management and Improvement
• Demonstrates a thorough understanding of the continuum of the revenue cycle.
• Improves operations through technology and process improvement.
• Effectively collaborates with IT and project management leaders for the successful planning and execution of revenue cycle-related applications/systems as part of information system transformation projects, including the integration of enterprise-wide clinical and revenue cycle systems designed to have a strategic impact on the core operations and processes of the organization.
• Leads the organization to continuously improve its revenue cycle performance continuum through data and metrics.
• Develops options, communicates, and builds support for recommendations to allow the organization to meet changing environment/regulatory requirements and to ensure the medical center receives appropriate reimbursement for services provided.
• Performs evaluation, process redesign, and implementation of healthcare business office functions including admissions/registration to facilitate accurate/timely billing, collections, and denials management.
• Leads development and implementation of consistent policies, procedures, and productivity standards to improve operations system-wide.
Customer Service/Reporting
• Maintains strong customer relationships with key strategic partners.
• Ensures appropriate functional strategic partners are engaged throughout the process.
• Monitors and provides regular reporting to senior management on key performance metrics (e.g., actual versus expected results for financial targets, budgets, compliance, quality, customer service, and productivity/efficiency).
• Brings developing issues and recommended actions to the attention of senior leadership and
governance committees.
• Ensures the quality of system deliverables, the quality of the work delivered by assigned functions, and compliance with formal service agreements.
Revenue Cycle Risk Management
• Directs and/or oversees analysis of issues to identify developing issues/changes/potential risks with the potential to impact the medical center.
• Provides oversight to ensure there is active and effective participation in key medical center compliance committees.
• Collaborates with the medical center to develop strategies and recommendations to mitigate risk.
• Develops, maintains, and ensures compliance with standardized policies, processes, and programs throughout the organization.
• Provides oversight to ensure required reports are filed on time and meet the highest levels of accuracy, compliance, and effectiveness.
• Oversees activities to ensure communication, coordination, policies/protocols, and audits are monitored and effective
Overall Management
• Develops a high-performing team as measured through the achievement of benchmark process outcomes, audit and compliance results, financial goals, and employee satisfaction.
• Stays current with government regulations regarding billing requirements.
• Drafts goals, objectives, and budgets for assigned areas, and monitors/manages to ensure achievement once approved.
• Ensures all HIPAA privacy and security standards are adhered to/followed.
• Conforms to the established policies/procedures/processes/Standards of Behavior and ensures assigned staff do so as well.
The Ideal Candidate:
The successful candidate will be an executive with significant (15-20 years plus) experience in and management of hospital operations, and, the financial/revenue cycle operations of a large (2bn+) integrated health system. In addition, she/he will ideally have experience:
• Managing all aspects of revenue cycle operations from initial patient contact through successful collection/reporting outcomes.
• Demonstrated track record of aligning the core values of the organization and proven negotiating skills.
• Revenue cycle-related healthcare provider-based design and optimization, consulting, and project management.
• Reviewing and managing contracts, managing contractor/vendor relationships, establishing service level agreements, and monitoring delivery of services provided.
• Implementing large shared services or managing outsourced functions.
• Leading large-scale change efforts.
• Implementing advanced technology including automation, patient web portals and payer exchanges.
Required Skills:
• Financial management skills, including the ability to analyze financial data for operations, budgeting, auditing, forecasting, accounting, AR and reserve analysis, market analysis, staffing, and financial reporting.
• Strong leadership skills to motivate cross-departmental teams’ performance towards excellence using team concepts and consensus-building management styles.
• Advanced/effective interpersonal, written/verbal communication, and presentation skills, along with the ability to communicate complex finance concepts to others without a finance background.
• Demonstrated ability to engage in positive, powerful persuasion with individuals or groups with diverse opinions and/or agendas, leading to outcomes that meet identified goals.
• Ability to analyze and resolve complex problems necessary to develop and administer multifaceted revenue cycles processes, regardless of whether issues originate in an area under direct or indirect control.
• Ability to enlist cooperation and build teams committed to carrying out initiatives in environments that may be resistant to change and not under the incumbent’s direct authority.
• Ability to translate key performance indicator levels into a finance-based business case, then design, implement, and manage more effective/efficient processes.
• The ability to maintain a high level of positive energy/creativity during periods of elevated work demands.
• Ability to prioritize multiple objectives in a rapidly changing environment and deliver quality outcomes.
• Ability to develop and maintain effective relationships at all levels throughout the organization.
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