JOB SUMMARY:

To promote the mission of PATH to help individuals achieve a more independent and fulfilling life by providing strategic leadership and oversight of the organization's revenue operations, revenue cycle, reimbursement management, client financial services, payer relationships, and revenue optimization activities that support the agency's financial health and long-term sustainability. The Senior Director, Revenue Operations is responsible for maximizing revenue performance, strengthening revenue integrity, improving reimbursement processes, and ensuring effective coordination of revenue-related functions across the organization. This position partners with the COO/CFO to support revenue forecasting, budgeting, financial analysis, operational and strategic decision-making, payer and funding initiatives, and organizational growth while promoting operational excellence, regulatory compliance, strong internal controls, and continuous improvement.

QUALIFICATIONS:
Master's Degree in Business Administration, Finance, Accounting, Healthcare Administration, Public Administration, Economics, or a related field required; Minimum ten (10) years of progressively responsible experience in revenue cycle management, reimbursement, healthcare billing, financial operations, or related fields, including at least five (5) years in a leadership role. Demonstrated experience in revenue optimization, reimbursement methodologies, revenue reconciliation, cash management, client financial services, operational analysis, and process improvement required. Experience within healthcare, behavioral health, human services, or nonprofit organizations preferred; Valid Driver's License and use of personal vehicle; Excellent computer skills with advanced proficiency in Microsoft Excel, data analytics tools, financial and accounting software, revenue cycle management systems, and other business applications as required. Ability to utilize technology and data to support revenue optimization, reimbursement management, operational decision-making, and continuous improvement initiatives.;Ability to create and present complex financial, reimbursement, operational, and revenue cycle analyses using various software applications, reporting tools, and databases. Demonstrated ability to utilize technology and data to support revenue optimization, reimbursement management, operational decision-making, and continuous improvement initiatives. Thorough knowledge of nonprofit accounting, healthcare reimbursement methodologies, revenue cycle management, financial operations, and regulatory requirements. Strong analytical, problem-solving, and process improvement skills.

SPECIFIC DUTIES

REVENUE CYCLE MANAGEMENT & REIMBURSEMENT

1. Provide leadership and oversight of the organization's revenue cycle operations, ensuring effective reimbursement processes, revenue integrity, and regulatory compliance.
2. Oversee billing, claims management, reimbursement activities, and collections to maximize revenue and minimize revenue leakage.
3. Monitor reimbursement trends, payer requirements, denial patterns, and regulatory changes that may impact organizational revenue.
4. Ensure timely and accurate submission of claims, invoices, vouchers, expenditure reports, and other reimbursement requests to funding sources.

REVENUE ANALYSIS, RECONCILIATION & REPORTING

1. Oversee revenue reconciliation processes to ensure the accuracy and completeness of revenue transactions, reimbursements, cash receipts, and supporting documentation.

2. Lead the monthly revenue close by coordinating reconciliations, analyses, required adjustments, and supporting schedules.

3. Partner with Finance & Accounting to ensure revenue is accurately reconciled, recognized, recorded, and reported in accordance with applicable accounting standards and organizational policies.

4. Develop revenue forecasts, trend analyses, and performance reports in partnership with the COO/CFO.

5. In partnership with the COO/CFO, support the development, monitoring, and analysis of annual revenue budgets, reimbursement assumptions, revenue projections, and long-range financial planning activities, identifying variances and recommending corrective actions as needed.

CLIENT FINANCIAL SERVICES

1. leadership and oversight of client financial services, including representative payee and non-representative payee programs.

2. Ensure compliance with applicable regulations governing client funds and financial services.

3. Oversee processes related to client benefits, liability determinations, room and board collections, and other client financial obligations.

4. Ensure accurate reconciliation, safeguarding, and reporting of client financial resources.

5. Develop and maintain procedures that support quality customer service and financial accountability for individuals served.

REVENUE STRATEGY, GOVERNANCE & CONTINUOUS IMPROVEMENT

1. Partner with the COO/CFO to identify and implement strategies that strengthen revenue performance, improve reimbursement outcomes, diversify revenue sources, and support the organization's long-term financial sustainability.

2. Identify and pursue opportunities to expand commercial insurance participation, third-party payer relationships, and new reimbursement opportunities.

3. Lead and coordinate strategic payer contracting, reimbursement negotiations, provider credentialing, recredentialing, and network participation activities by conducting financial and operational analyses, facilitating the review process, developing recommendations, and supporting Executive Committee decision-making and approval.

4. Evaluate revenue cycle workflows, reimbursement processes, and operational practices to identify opportunities for improvement.

RFP, CONTRACT SUBMISSION & RENEWAL MANAGEMEN

1. Lead and coordinate revenue-related Requests for Proposals (RFPs), funding applications, contract submissions, and related procurement or competitive application processes.

2. Develop and maintain a centralized process for tracking RFP opportunities, submission requirements, responsible parties, required documentation, internal approvals, deadlines, and final submissions.

3. Coordinate with executive leadership, Finance & Accounting, program leadership, Quality Improvement, Compliance, and other applicable departments to gather accurate programmatic, operational, financial, credentialing, and supporting information required for RFPs and contract submissions.

4. Ensure RFPs, funding applications, contract documents, and supporting materials are complete, accurate, responsive to funding-source requirements, internally approved, and submitted by established deadlines.

5. Maintain organized and accessible records of RFPs, proposals, contracts, amendments, award notices, correspondence, supporting documentation, submission confirmations, and final executed agreements.

6. Manage and monitor the annual contract renewal process for revenue-generating agreements, payer arrangements, funding-source contracts, and other assigned contractual relationships.

COMPLIANCE, AUDIT & RISK MANAGEMENT

1. Ensure compliance with applicable federal, state, local, payer, and contractual requirements related to billing, reimbursement, and client financial services.

2. Lead revenue-related audit preparation and support internal and external audits by ensuring appropriate documentation, reconciliations, supporting schedules, and operational readiness.

3. Develop, implement, and maintain internal controls, compliance procedures, and financial control processes related to revenue operations and client financial services.

4. Monitor compliance risks and implement corrective actions as necessary.

STAFF LEADERSHIP & DEVELOPMENT

1. Provide leadership, coaching, performance management, and professional development to assigned staff.

2. Ensure appropriate cross-training, succession planning, and operational coverage within Revenue Operations.

3. Promote a culture of accountability, customer service, collaboration, continuous improvement, and operational excellence.

4. Perform other duties as assigned.