This Director position is in La Jolla and requires residence in San Diego County. Eligible to participate in the Director Incentive Plan. The Director, Revenue Cycle - Transactions Operations & Informatics is a strategic leader who blends operational excellence with data-driven innovation. This role oversees revenue cycle transaction functions, including cash posting, payment reconciliation, electronic remittance processing, payer connectivity. Over time, this leader will assume progressive accountability for Revenue Cycle Informatics, partnering with operational, IS, and other key stakeholders to advance reporting, automation, workflow intelligence, data integrity, and technology-enabled performance improvement across the revenue cycle.
Responsibilities of the role: - Lead all signed revenue cycle operations with a focus on transactional excellence, automation, and digital enablement to drive measurable improvements in cash acceleration, accuracy, and efficiency,
- Oversee transactional operational including payment postings, EDI workflows, automation initiatives, and vendor integrations, ensuring process standardization and system integrity across all sites.
- Lead and mentor direct reports and staff beneath them in a manner that inspires them to lead and execute their duties and responsibilities in line with Scripps's vision and mission. Culture an environment where growth and learning are demonstrated, leading to an ever-increasing improvement in efficiency and excellence.
- Direct supervision of vendor contract, including Timely, accurate and consistent fulfillment of negotiated deliverables; Scheduled performance review and reporting; Invoice monitoring and payment; contract updates as needed; Regular meeting / updates on vendor results; Review of services at term breaks to determine best options between continuation or solicitations to stay current with best practices
- Partner across cross functional team to advance technology-driven initiatives such as robotic process automation (RPA), API integration, and data visualization for real-time decision support.
- Build and lead a high-performing, analytically fluent team that leverages Epic, automation tools, and data insights to optimize performance and proactively solve complex operational challenges, as well as proposing process improvements to keep Scripps on the cutting edge. Cultivate collaborative relationships with internal stakeholders and payer partners to identify trends, resolve systemic barriers, and enhance digital transaction quality and payer connectivity.
- Ensure compliance with all applicable regulations and stay current on industry trends and best practices.
- Serve as a strategic architect for future state end-to-end revenue cycle design, incorporating AI readiness, predictive analytics, and automation scalability into long-term plans.
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Qualifications Requirements: - Bachelors of Science or Arts, Finance or Business.
- 5 years of healthcare admitting registration/finance/patient accounting plus 5 years of progressive level of multi-hospital system management responsibility including operations redesign and project management.
- Knowledge of Federal/State/County/Commercial Insurance Payers requirements.
Preferred Education/Experience/Specialized Skills/Certification: - Masters in Business, Healthcare Administration, and Finance preferred
- HFMA Certified Patient Accounting Manager (CPAM), NAHAM Certified Healthcare Access Manager (CHAM), Certified Healthcare Financial Professional (CHFP) or HFMA Fellow (FHFMA) preferred.
- Extensive billing knowledge and experience.
- Ability to connect transaction performance data to operational interventions, including staffing models, payer escalation, and automation.
- Epic HB/PB revenue cycle experience, including payment posting, remittance, account work queues, and reporting.
- Direct experience with 835 electronic remittance, 837 claims, payer edits, clearinghouse workflows, and EDI exception resolution.
- Demonstrated success reducing manual posting, increasing electronic remittance adoption, improving auto-post rates, and reducing unapplied or unidentified cash.
- Experience managing transaction-related vendors, including clearinghouses, payment processors, lockbox vendors, RPA/automation partners, and offshore/outsourced operational teams.
- Strong understanding of internal controls, audit readiness, segregation of duties, refund controls, recoupment management, and payment posting compliance.
- Expertise in Epic Revenue Cycle, payer connectivity, and RPA or workflow automation tools.
- Experience dealing with commercial payers, governmental entities and financial institutions EDI processes.
- Demonstrated experience driving digital transformation, data-driven decision making, and AI enablement within revenue cycle operations.
