Description: Directs revenue cycle initiatives to build compliant, comprehensive non-dues revenue cycle. Oversees coordination and standardization, work integration, change management, issue resolution, and measurement and communication related to non-dues revenue cycle initiative. Develops overall vision and implementation plans to effectively support organizational strategies for new product offerings requiring billing capability. Identifies and develops necessary infrastructure to support implementation of strategies. Coordinates efforts with Kaiser Permanente's national function to establish organization-wide metrics, processes, procedures, templates and collaborative tools to support revenue cycle. Directs Patient Accounts function. Communicates key issues and provides status updates to various leadership groups and stakeholders. Serves as role model. Supervises assigned staff.
- Provides leadership and direction for revenue cycle initiatives. Leads through collaborative processes to implement comprehensive and compliant non-dues revenue cycle procedures.
- Identifies key performance and project metrics to effectively manage operations. Measures and reports noteworthy statistical and status information.
- Facilitates development and implementation plans to operationalize revenue cycle initiatives and strategies.
- Fosters strategic relationships with sponsors, stakeholders, contributors and key internal parties across functions. Leads, coordinates, guides and influences necessary parties to achieve desired transformation.
- Ensures alignment of Kaiser Permanente Health Plan/Hospital (KPHP/H) and Hawaii Permanente Medical Group (HPMG) leadership on revenue cycle issues.
- Implements necessary internal controls to ensure regulatory and policy compliance.
- Implements plans/projects to improve operational efficiency and effectiveness. Monitors and reports status and progress to supervisor.
- Identifies opportunities to leverage systems, processes, standardization or other vehicles to lower cost while maintaining or improving customer service.
- Monitors expenditures, ensures compliance with budget. Promotes effective use of resources.
- Seeks efficient ways to carry out operations within areas of responsibility. Writes department policies and procedures. Assures policies, procedures, and performance goals and measures are met. Reports on areas' operational goal attainment. Participates in interdepartmental activities necessary to meet region wide plans.
- Acts as resource to peripheral clinics and departments in matters pertaining to billing, reporting, and reimbursement.
- Demonstrates knowledge of regulatory billing requirements for CMS, Workers Compensation, Third Party Payors, Medicaid for both Hospital & Professional billing.
- Researches and analyzes data to determine where problems exist. Audits billing documentation and data. Develops solutions. Provides follow-up training, changes in procedures. Prepares reports to management.
- Hires, trains, supervises, counsels, disciplines, and terminates assigned staff as appropriate.
- Communicates goals, objectives, accountabilities, priorities, and authority parameters to assigned staff.
- Minimum eight (8) years of revenue cycle, financial operations management, internal control or related field experience.
- Minimum three (3) years of management experience.
- Bachelor's degree in healthcare administration, accounting, finance, business administration or related field OR four (4) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- Knowledge of insurance, managed care and integrated delivery systems.
- Demonstrated knowledge of and skill in change management, conflict resolution, creativity/innovation, decision making, group
- presentations, group process facilitation, influence, interpersonal relations, oral communication, problem solving, process improvement, project management, results orientation, systems thinking, team building, and written communication.
- Demonstrated knowledge of and skill in word processing, multimedia presentations, spreadsheet, and database PC applications.
- Related experience in a healthcare setting.
- Master's degree in healthcare administration, accounting, finance, business administration or related field.
Job Number: 619887