Executive Director Revenue Cycle

Southwest General Health Center is a 352-bed community hospital that began in 1920 and has grown into offering a full range of services in partnership with University Hospital of Cleveland. This is the last community hospital in the region. Taking great pride in providing high quality affordable patient care, this organization has been recognized by several organizations and has won Best Places to work, as well as the NorthCoast 99 Award for fourteen years as a testament to their culture and stable leadership team.In this role as the Executive Director of Revenue Cycle:Reporting to the System Chief Financial Officer, the Executive Director, Revenue Cycle (EDRC) provides leadership and direction and is responsible for the revenue cycle functions for both the hospital and the employed medical group.The EDRC will have direct oversight for the management of Southwest’s end-to-end revenue cycle functions including patient access, authorizations, registration, scheduling, revenue integrity, health information management, utilization management, clinical documentation improvement, denials management, and the outsourced billing and collections vendors.EDRC is responsible for strategic and systemic approaches that contribute to the capture, management, and collection of patient service revenue. Advises and oversees investments and changes in software applications, outsourcing vendors, recovery projects, and other interventions to collect the net revenue associated with patient services. The EDRC must be able to coordinate processes across the health system and facilitate cooperation amongst diverse departments and business units reporting to other health system executives. Great opportunity for process improvement.A successfully prepared candidate in this role would have:Bachelor’s degree in Finance, Accounting, Business, or Healthcare Administration or other relevant field required. Masters degree in Business Administration preferred.Minimum of seven (7) years of experience in revenue cycle management, enrollment, billing, payment processing, or similar operations required.Minimum of three (3) years of recent leadership or progressive supervisory experience required.Strong knowledge of CMS, revenue cycle functions, healthcare billing, coding, and reimbursement processes.Considerable knowledge of medical office operations, professional fee billing, reimbursement, and third-party payer regulations and medical terminology is required.Knowledge of ICD-10 Codes, CPT Codes, HCPCS Codes, Revenue Codes, and Place of Service Codes.Intermediate-level experience working in Microsoft Excel is highly preferred.KEY RESPONSIBILITIES AND DUTIESCollaborate with System and department leadership teams, including hospital, Medical Group, and IT leadership to achieve the vision and strategic direction for revenue cycle, reimbursement, and revenue integrity business functions.Plan, develop, and implement new systematic approaches to maximizing revenue, improve financial performance, generate cash flow, and improve operational efficiency.Responsible for centralized analysis and project management of Revenue Cycle performance improvement initiatives.Develop the organizational framework to adopt a metrics driven balanced scorecard for assessing revenue cycle and contract performance effectiveness in relation to industry benchmarks.Develop targeted strategies to improve patient satisfaction with the revenue cycle/patient billing process.Facilitate a matrixed approach in the development and redesign of business processes. Ability to work effectively with the health system’s organizational structure in planning and conducting needs-assessment activities to implement business solutions that improve operational processes.Lead multi-disciplinary teams and committees pertaining to service and functional areas.Provide advisory and operational assistance in the acquisition, development, and implementation of revenue cycle business systems.Provide leadership and direction to the patient financial services function to ensure the efficient operation of all aspects of the revenue cycle. In doing so, monitor and report on quality and cycle time measures/benchmarks for patient financial services.Maintain expertise in reimbursement methodologies and regulatory changes as they apply to payor contracts.Ensure completion of various financial forecasts including cost center salary and direct expenses, month-end financial reporting, receivable levels, cost center productivity, and any long-range and strategic plans for the department.Liaison with physicians and other stakeholders with respect to Revenue cycle information and projects. Work with physician leaders and department managers throughout the organization on revenue cycle initiatives related to their areas of responsibility.Oversee the process of development of standard work for the organization with respect to all revenue cycle activities including policy determination. Ensure that all policy decisions and standard work are appropriately documented and readily available for all in the organization to access.Leadership development including coaching, mentoring, retention, and constructive feedback for the Revenue Cycle leadership team. Identify gaps in training or skills and make adjustments as necessary.

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