Director of Revenue Integrity

Steward Health Care   •  

Brighton, MA

Industry: Misc. Healthcare


11 - 15 years

Posted 423 days ago

This job is no longer available.

Position Summary

Reporting to the VP of Revenue Cycle, this management level Director is responsible for Revenue  Management functions throughout the Steward Medical Group system utilizing consultative, persuasive, direct leadership and centralized/decentralized management methods. This Director is expected to identify how best to use system-wide  resources encompassing Coding, Provider Education and other revenue cycle resources with the goal of optimizing reimbursement and maintaining compliance.

Essential Functions

Strategic Planning/System
• Provides strategic thought leadership along with the VP of Revenue Cycle across the Revenue Cycle Management continuum.
• Participates in defining and implementing long term strategies to create revenue cycle operation scale and/or to position SMG to react and manage more quickly and effectively to future billing, payment and collection challenges.
• Co-leads the design of the SMGs revenue cycle process structure for coding, provider education, provider enrollment, business intelligence and analytics, referral and authorizations, managed care and payer relations, and revenue performance managers, which streamlines the workflow and eliminates redundancy.
• Facilitates communication between internal business customers.
• Drives consensus among key stakeholders.

Cash Flow Generation
• Directs, manages, and implements programs and strategies to ensure efficient operations of SMG's revenue cycle in order to generate the optimal cash flow to support SMG's operations and strategic initiatives.
• Coordinates and directs internal staff and external resources, such as consultants and subject matter experts, in order to meet the specific objectives and time tables for identified revenue cycle initiatives and related strategies.
• Develops and implements centralized revenue cycle solutions where the value proposition indicates revenue  or cost improvement opportunities.
• Provides knowledge transfer, project management, facilitation, analytical support, and communications, depending upon the nature of the initiative.
• Reviews, monitors, and assists in the explanation of performance against budget and benchmarks.
• Occasionally is called upon to provide and direct local tactical revenue cycle operational support to Members.
•  Is responsible for optimizing business performance by enhancing the alignment between business processes  and information technology.

• Ensures compliance with all Federal and State regulations regarding billing procedures.
• Establishes effective internal controls regarding all functional work flows.

Customer Service 
• Models service orientation to internal and external customers; ensures service delivery is among the top priorities for revenue cycle operations.

• Provides leadership in support of the organization's mission/vision/values, providing guidance and direction in a  complex environment. Effectively manages financial and human capital resources. Role models desired leadership  behaviors including, but not limited to: integrity, ethics, trust, open and honest communications. Directs  performance holding self and others accountable for creating a safe environment for all and for delivering high  quality services to those served by the organization. 

Required Minimum Knowledge, Skills, and Abilities

• Bachelor's degree in a related field required or equivalent experience.
• Minimum of ten (10) years or relevant experience with a track record of progressively responsible positions in a   complex healthcare related organization such as multi-hospital system, large group practice or a major healthcare consulting firm preferred.
• Broad understanding and experience within physician practice  operations, and other health care services.
• Demonstrated progression in experience and responsibility in revenue cycle operations including practice operations management, accounts receivable management, and  Health Information Management with a proven track record  of leading complex projects to successful completion.
• Strong working knowledge of managed care contracting strategies, billing and collection processes and functions, practice operations , Health Information Management, and general revenue cycle management strategies, and industry best practices.
• Demonstrated strategic thinking and planning abilities.
• Ability to lead both through influence and direct authority.
• Excellent communication, presentation, and facilitation skills with the ability to effectively communicate and lead   a broad range of audiences.
• Knowledge and application of Performance Improvement concepts.