Children's National Medical Center
VP Revenue Cycle & Care Management
Children's National Medical Center, Washington, District of Columbia, us, 20022
Job Description - VP Revenue Cycle & Care Management (240002BL)
VP Revenue Cycle & Care Management - (240002BL)
Description
The VP Revenue Cycle & Care Management will lead the integrated clinical and financial functions to contribute to optimal reimbursement for efficient clinical services. Oversee all administrative functions to contribute to the authorization, capture, management, and collection of patient service revenue. Will be responsible to enhance and maintain a properly functioning care management and revenue cycle process through a cross department organizational structure and dual reporting relationship to the CFO and COO. Will align clinical services and programs with revenue capture to achieve the highest level of clinical and financial outcomes. The VP will concentrate on financial and clinical resources to assist the management team and applicable department heads to improve the overall effectiveness and efficiencies of care management to support timely billing and contract compliance. Critical responsibilities include achievement of annual and periodic goals for significant statistical indicators of utilization and revenue cycle performance and for the organization's overall financial performance. Will serve as the functional representative in leadership meetings regarding care management and revenue cycle improvements and initiatives. Will maintain a focus on continuous improvement within the area of influence and deliver the highest degree of quality service possible. The VP will work on special projects as directed by the CFO and COO.
Qualifications
Minimum EducationMaster's Degree Hospital Administration, Nursing Administration or other related field. (Required)
Minimum Work Experience13 years Progressive related experience. Minimum of 10 years supervisory/management experience in related job function. (Required)
Required Skills/KnowledgeExtensive knowledge of case management, patient registration, medical records, clinical documentation improvement, patient accounting, billing and revenue integrity management functions, process improvement preferred.Demonstrated leadership and management skills.Excellent written and verbal communication skills.Experienced in financial management, case management and personnel communication.
Required Licenses and CertificationsFHFMA, CPA, CCM, CMA, or CIA certification (Preferred)
Functional Accountabilities
Organizational Leadership
Lead the strategic planning of care management and revenue cycle functions, including establishing the vision, mission, short-term and long-term goals.Plan, implement, direct, and evaluate care management and revenue cycle functions on a strategic and operational level to support the vision, mission and strategic plan for CNMC.Develop a communication strategy and tools to ensure the effective communication of all departmental programs to CNMC management and staff.Complete (or contribute to the completion of) various financial forecasts, including cost center salary and direct expenses, month-end financial reporting, receivables levels (days in AR and aging), cost center productivity, and any long-range strategic plans for the department.Direct the administration and measurement of care management activities across the enterprise to achieve the best possible outcome and financial return through innovative programs related to the strategic direction of the organization.Work to continually enhance, improve and assure optimal efficiency of these programs/ business units.
Organizational Relationships
Assess and monitor organizational staffing requirements and align managed functions to effectively and efficiently meet organizational needs.Define, set and utilize appropriate key performance indicators and quality measures for care management and revenue cycle functions.Build the breadth and depth of the organization’s human capacity through competency assessment, succession planning and career development.Form a top team that possesses balanced capabilities to setting the mission, values and norms, as well as to hold the team members accountable individually and as a group for high quality results.Establish, build and sustain professional contacts with key stakeholders internally and externally.Serve as a resource to leaders across the organization looking to enhance care management and revenue cycle processes and outcomes.
Information Technology
Identify opportunities in the use of existing and new administrative and clinical information technology and decision-support tools to improve care management and revenue cycle performance efficiency and productivity.Leverage the use of administrative and clinical information technology and decision-support tools in process and performance improvement related to patient access, care management, patient financial services, health information management, and revenue integrity.Actively sponsor the utilization and continuous upgrade of information management capabilities to meet current and future organizational needs related to revenue cycle and care management.
Budget and Financial Management
Lead the strategic planning and development of operating and capital budgets for the managed functions. Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.Monitor key performance indicator financial reports and evaluate variances; recommend interventions for variance corrections; oversee the financial interface between and performance analysis of the patient financial services functions and fiscal services functions to produce and report reliable metrics.Oversee the integrity of financial and clinical interfaces, while facilitating the development of strategic system planning to enhance care delivery which will result in optimal revenue capture.Oversee the maintenance of the Charge Description Master and Revenue Integrity from a regulatory and strategic perspective.Evaluate and monitor performance of Managed Care contracts for problematic terms, language, administrative/clinical red-tape and loopholes with financial implications.Supervise internal and external audits related to individual accounts and revenue cycle processes.
Care Management
Lead care management programs to ensure efficient and effective care management throughout the enterprise. Oversee the clinical financial interface with care delivery teams, post-acute providers, community resources, state programs and payers for services to achieve highest level clinical, financial, quality and satisfaction outcomes.Monitor key performance indicator utilization reports and evaluate variances; recommend interventions for variance corrections.Develop and support structures and processes to facilitate participation by physicians, pharmacists, nurses, Social Workers and other health professionals in interdisciplinary care coordination for optimal care delivery across the enterprise.Integrate departments and teams to form collaborative partnerships to improve service delivery in a cost effective and satisfying manner.Identify the emerging care delivery models and innovations to be assimilated, integrated and introduced within the organization which will significantly impact the enterprise; create opportunities in the use of best practice clinical pathways to reduce costs and improve clinical effectiveness.Direct and evaluate the effectiveness of the utilization management activities and programs, then implement processes to continually improve performance, mitigate financial losses, and enhance reimbursement.
Organizational AccountabilitiesOrganizational Accountabilities (Staff)Organizational Commitment/IdentificationTeamwork/CommunicationPerformance Improvement/Problem-solvingCost Management/Financial ResponsibilitySafety
Primary LocationDistrict of Columbia-Washington
Work LocationsCN Hospital (Main Campus) 111 Michigan Avenue NW Washington 20010
JobOrganizationFinance
Position Status: R (Regular) - FT - Full-Time
Job PostingAug 16, 2024, 2:56:50 PM
Full-Time Salary Range150000 - 450000
Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law.
Please note that it is the policy of Children's National Hospital to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors).
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VP Revenue Cycle & Care Management - (240002BL)
Description
The VP Revenue Cycle & Care Management will lead the integrated clinical and financial functions to contribute to optimal reimbursement for efficient clinical services. Oversee all administrative functions to contribute to the authorization, capture, management, and collection of patient service revenue. Will be responsible to enhance and maintain a properly functioning care management and revenue cycle process through a cross department organizational structure and dual reporting relationship to the CFO and COO. Will align clinical services and programs with revenue capture to achieve the highest level of clinical and financial outcomes. The VP will concentrate on financial and clinical resources to assist the management team and applicable department heads to improve the overall effectiveness and efficiencies of care management to support timely billing and contract compliance. Critical responsibilities include achievement of annual and periodic goals for significant statistical indicators of utilization and revenue cycle performance and for the organization's overall financial performance. Will serve as the functional representative in leadership meetings regarding care management and revenue cycle improvements and initiatives. Will maintain a focus on continuous improvement within the area of influence and deliver the highest degree of quality service possible. The VP will work on special projects as directed by the CFO and COO.
Qualifications
Minimum EducationMaster's Degree Hospital Administration, Nursing Administration or other related field. (Required)
Minimum Work Experience13 years Progressive related experience. Minimum of 10 years supervisory/management experience in related job function. (Required)
Required Skills/KnowledgeExtensive knowledge of case management, patient registration, medical records, clinical documentation improvement, patient accounting, billing and revenue integrity management functions, process improvement preferred.Demonstrated leadership and management skills.Excellent written and verbal communication skills.Experienced in financial management, case management and personnel communication.
Required Licenses and CertificationsFHFMA, CPA, CCM, CMA, or CIA certification (Preferred)
Functional Accountabilities
Organizational Leadership
Lead the strategic planning of care management and revenue cycle functions, including establishing the vision, mission, short-term and long-term goals.Plan, implement, direct, and evaluate care management and revenue cycle functions on a strategic and operational level to support the vision, mission and strategic plan for CNMC.Develop a communication strategy and tools to ensure the effective communication of all departmental programs to CNMC management and staff.Complete (or contribute to the completion of) various financial forecasts, including cost center salary and direct expenses, month-end financial reporting, receivables levels (days in AR and aging), cost center productivity, and any long-range strategic plans for the department.Direct the administration and measurement of care management activities across the enterprise to achieve the best possible outcome and financial return through innovative programs related to the strategic direction of the organization.Work to continually enhance, improve and assure optimal efficiency of these programs/ business units.
Organizational Relationships
Assess and monitor organizational staffing requirements and align managed functions to effectively and efficiently meet organizational needs.Define, set and utilize appropriate key performance indicators and quality measures for care management and revenue cycle functions.Build the breadth and depth of the organization’s human capacity through competency assessment, succession planning and career development.Form a top team that possesses balanced capabilities to setting the mission, values and norms, as well as to hold the team members accountable individually and as a group for high quality results.Establish, build and sustain professional contacts with key stakeholders internally and externally.Serve as a resource to leaders across the organization looking to enhance care management and revenue cycle processes and outcomes.
Information Technology
Identify opportunities in the use of existing and new administrative and clinical information technology and decision-support tools to improve care management and revenue cycle performance efficiency and productivity.Leverage the use of administrative and clinical information technology and decision-support tools in process and performance improvement related to patient access, care management, patient financial services, health information management, and revenue integrity.Actively sponsor the utilization and continuous upgrade of information management capabilities to meet current and future organizational needs related to revenue cycle and care management.
Budget and Financial Management
Lead the strategic planning and development of operating and capital budgets for the managed functions. Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.Monitor key performance indicator financial reports and evaluate variances; recommend interventions for variance corrections; oversee the financial interface between and performance analysis of the patient financial services functions and fiscal services functions to produce and report reliable metrics.Oversee the integrity of financial and clinical interfaces, while facilitating the development of strategic system planning to enhance care delivery which will result in optimal revenue capture.Oversee the maintenance of the Charge Description Master and Revenue Integrity from a regulatory and strategic perspective.Evaluate and monitor performance of Managed Care contracts for problematic terms, language, administrative/clinical red-tape and loopholes with financial implications.Supervise internal and external audits related to individual accounts and revenue cycle processes.
Care Management
Lead care management programs to ensure efficient and effective care management throughout the enterprise. Oversee the clinical financial interface with care delivery teams, post-acute providers, community resources, state programs and payers for services to achieve highest level clinical, financial, quality and satisfaction outcomes.Monitor key performance indicator utilization reports and evaluate variances; recommend interventions for variance corrections.Develop and support structures and processes to facilitate participation by physicians, pharmacists, nurses, Social Workers and other health professionals in interdisciplinary care coordination for optimal care delivery across the enterprise.Integrate departments and teams to form collaborative partnerships to improve service delivery in a cost effective and satisfying manner.Identify the emerging care delivery models and innovations to be assimilated, integrated and introduced within the organization which will significantly impact the enterprise; create opportunities in the use of best practice clinical pathways to reduce costs and improve clinical effectiveness.Direct and evaluate the effectiveness of the utilization management activities and programs, then implement processes to continually improve performance, mitigate financial losses, and enhance reimbursement.
Organizational AccountabilitiesOrganizational Accountabilities (Staff)Organizational Commitment/IdentificationTeamwork/CommunicationPerformance Improvement/Problem-solvingCost Management/Financial ResponsibilitySafety
Primary LocationDistrict of Columbia-Washington
Work LocationsCN Hospital (Main Campus) 111 Michigan Avenue NW Washington 20010
JobOrganizationFinance
Position Status: R (Regular) - FT - Full-Time
Job PostingAug 16, 2024, 2:56:50 PM
Full-Time Salary Range150000 - 450000
Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law.
Please note that it is the policy of Children's National Hospital to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors).
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