Strategic Leadership And Performance Management- Develop and execute a comprehensive post-billing strategy that leverages global resources, technology and stateside resources to maximize yield and minimize cost.
- Lead multi-disciplinary teams across follow-up, denials, appeals, payer relations, and patient financial engagement.
- Establish KPIs, dashboards, and analytics frameworks to monitor performance across domestic and offshore operations; and the overall post-billing operations.
- Serve as the organization's authority on the No Surprises Act (NSA), including IDR processes, NSA methodologies and operations, and payer compliance trends.
- Partner with executive peers to ensure seamless integration across the entire revenue cycle.
- Oversee all Human Capital planning related to operational budgets and workflows throughout the post-billing process.
- Develop strategic initiatives and annual operational goals for Revenue Cycle Services that align with corporate objectives, and drive program and project success measures.
- Establish and maintain a consistent delivery framework and collaborative approach for the Revenue Cycle Services Client Management team, ensuring high standards for client-facing activities in partnership with SCP Health Business Development, Clinical, and Staffing Operations teams.
- Engage proactively in strategic planning to lead innovation in patient engagement, technology adoption, and the integration of artificial intelligence (AI), robotic process automation (RPA), and system automations to enhance workflows and optimize revenue cycle performance
Operational Excellence and Financial Optimization- Oversee all post-billing workflows to ensure timely, accurate, and compliant resolution of accounts.
- Drive initiatives to reduce denials, accelerate cash flow, and maximize net collections.
- Ensure a high-quality patient financial experience across all patient touchpoints.
Global Workforce Leadership- Architect and oversee a global delivery model where offshore teams represent a significant portion of operational capacity.
- Lead large offshore teams across multiple geographies, ensuring alignment with U.S. regulatory requirements, payer expectations, and organizational standards.
- Implement global workforce planning strategies to balance cost, quality, scalability, and risk.
- Ensure global operations support enterprise-level financial goals and margin expectations.
AI, Automation and Technology Enablement- Champion the adoption of AI-driven tools, predictive analytics, and automation to enhance productivity and reduce manual work across teams.
- Partner with IT and vendors to implement technologies for denials prediction, automated appeals, intelligent work routing, payer behavior modeling, and NSA needs.
Vendor and BPO Management- Serve as the executive operational owner of all post-billing offshore vendor relationships, RCM point solutions (i.e. patient engagement vendor), and technology-enabled service providers.
- Negotiate contracts, SLAs, pricing models, and performance guarantees to ensure cost-effective, high-quality delivery.
- Establish governance structures, QBRs, and continuous-improvement programs to maintain accountability and operational excellence.
- Drive vendor innovation, ensuring partners adopt AI, automation, and analytics in alignment with organizational strategy.
Payer Strategy and Behavior Analytics- Develop payer-specific strategies informed by deep analysis of reimbursement patterns, denial trends, and underpayment behavior.
- Lead executive-level payer escalations to resolve systemic issues.
- Build strong payer relationships to influence policy and reduce operational friction.
- Work with SCP's Managed Care team on payer strategy and issues.
Financial Revenue Model Alignment- Leverage a deep understanding of how revenue cycle performance drives financial outcomes, including net revenue yield, contribution margin, cash acceleration, and forecasting accuracy.
- Partner with Finance to translate operational performance into revenue projections, budget models, and scenario-based forecasting.
- Use RCM analytics to identify revenue leakage, quantify financial impact, and drive initiatives that improve overall financial performance.
Regulatory and Compliance Expertise- Ensure full compliance with all billing and collection practices.
- Ensure offshore teams operate within U.S. regulatory frameworks through training, auditing, and compliance oversight.
- Collaborate with Legal and Compliance teams to mitigate risk and respond to regulatory changes.
- Ensure compliance with all applicable healthcare payer regulations, guidelines, and relevant state and federal laws.
Client Service and Business Development- Proactively engage Divisional Operations teams whose actions may influence efficiency, accuracy, effectiveness, or compliance of billing and collections for reimbursable services.
- Review, analyze, and recommend pricing structures for existing and prospective contracts.
- Collaborate on integration strategies to support new business and increased volume.
Pay Range:
156,648.00 - 259,706.00 USD annually
This range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations.
We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources.
Visit our website for further information.
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