Job Summary

Director, Business & Revenue Practice Plan

The Director, Business & Revenue Practice Plan works closely with revenue-generating practices and Revenue Cycle departments to enhance revenue capture, develop educational materials, perform focused reviews, and monitor key revenue metrics to ensure best practices within Epic. As a member of the Practice Plan Leadership Team, this role serves as a key liaison between physician practices and Revenue Integrity leadership to ensure revenue cycle policies and procedures support reimbursement optimization and regulatory compliance.

The Director collaborates with practice leadership, professional coding, accounts receivable management, and Revenue Cycle teams to identify trends, improve workflows, reduce denials, and enhance overall revenue cycle performance. This position is responsible for monitoring operational and financial performance, educating stakeholders, and driving process improvements that support organizational goals.

Key Responsibilities

• Monitor open encounters and identify patterns requiring escalation, partnering with practice management to establish and maintain consistent expectations.
• Monitor reports and operational metrics to ensure process changes do not negatively impact charge capture.
• Develop and provide training to leadership and practice management regarding charge reconciliation standards, expectations, and revenue cycle best practices.
• Collaborate with Coding and Department Leaders to assign CPT and HCPCS codes, revenue codes, and reimbursement fees, while validating that new codes and updates are accurately entered into Epic.
• Review existing charges annually and work with coding teams to implement appropriate changes based on regulatory updates.
• Meet with key stakeholders regarding the development and maintenance of the Charge Description Master (CDM), coordinating, monitoring, and obtaining leadership approval for changes.
• Understand practice workflows, identify trends, and partner with Practice Management to develop improvements that support operational efficiency and minimize denials.
• Review information related to denials, charges, and payments, making recommendations to improve processes and collaborating with other departments to implement solutions.
• Routinely report on revenue cycle performance, including key performance indicators, benchmarks, and operational metrics.
• Collaborate with professional coding and accounts receivable management to understand denial trends, identify root causes, and develop mitigation plans.
• Partner with Revenue Integrity leadership to ensure revenue cycle policies and procedures align with organizational goals, reimbursement requirements, and compliance standards.

#STC

Qualifications

Education

• Bachelor's Degree.
• A combination of relevant education and experience may be considered in lieu of a Bachelor's Degree.
• Completes and maintains all competencies and training requirements associated with the role.

Experience

Qualified candidates will possess:

• Progressive experience in healthcare revenue cycle, physician practice operations, revenue integrity, or reimbursement.
• Demonstrated expertise with Epic Revenue Cycle, including charge capture, charge reconciliation, reporting, and workflow improvement.
• Experience collaborating with physician practices, coding, and accounts receivable teams to optimize revenue cycle performance and reduce denials.
• Knowledge of CPT/HCPCS coding, revenue codes, reimbursement methodologies, and charge review processes.
• Experience analyzing revenue cycle metrics and leading education, process improvement, and operational initiatives.

• Leadership experience within a physician practice, healthcare operations, revenue cycle, or revenue integrity environment.
• Experience collaborating with coding, denial management, and accounts receivable teams to improve revenue cycle performance.

Why Join Us

This is an opportunity to play a critical leadership role in optimizing revenue cycle performance across physician practices. The Director, Business & Revenue Practice Plan will have the ability to influence operational excellence, enhance revenue capture, support compliance initiatives, and partner with leaders across the organization to drive meaningful results.