Senior Vice President, Revenue Cycle

Job Summary:

The Senior Vice President (SVP) of Revenue Cycle is a key executive leader responsible for the strategic direction, operational performance, and financial integrity of WMCHealth Network revenue cycle functions. The SVP provides enterprise-wide leadership for patient access, health information management, coding, clinical documentation improvement, charge capture, billing, collections, denials management, reimbursement, and revenue integrity. This role partners closely with executive leadership, physician leadership, finance, compliance, information technology, and operational departments to optimize revenue, improve patient financial experience, ensure regulatory compliance, and support organizational growth

Responsibilities:

Strategic Leadership

• Develop and execute a comprehensive revenue cycle strategy aligned with organizational goals and financial objectives.
• Serve as the executive leader for all revenue cycle operations across acute care, ambulatory, physician, and ancillary services.
• Lead revenue optimization initiatives that enhance cash flow, reduce denials, and improve reimbursement.
• Identify opportunities for process improvement, automation, and technology innovation within the revenue cycle.
• Partner with executive leadership to support growth initiatives, mergers, acquisitions, and service line expansion.

Revenue Cycle Operations

Oversee all revenue cycle functions, including:

• • Patient Access and Registration
  • Financial Clearance and Authorization
  • Health Information Management (HIM)
  • Clinical Documentation Improvement (CDI)
  • Medical Coding
  • Charge Capture and Revenue Integrity
  • Billing and Claims Management
  • Government and Commercial Reimbursement
  • Accounts Receivable Management
  • Denials Prevention and Resolution
  • Patient Financial Services
• Ensure efficient workflows and standardized practices across the organization.
• Monitor operational and financial performance and drive accountability for results.

Financial Performance

Achieve organizational goals related to:

• • Net patient revenue
  • Cash collections
  • Accounts receivable days
  • Clean claim rates
  • Denial rates and recovery
  • Revenue capture
• Develop financial forecasts and revenue cycle performance metrics.
• Identify reimbursement opportunities and mitigate revenue leakage.
• Collaborate with Finance on budgeting, forecasting, and financial reporting.

Compliance and Risk Management

• Ensure compliance with federal, state, and local regulations related to billing, coding, reimbursement, and patient financial services.
• Maintain adherence to CMS, Medicare, Medicaid, Joint Commission, and payer requirements.
• Oversee audits and implement corrective action plans as necessary.
• Partner with Compliance and Legal teams to minimize organizational risk.

Technology and Data Analytics

• Lead optimization of revenue cycle technologies, including EHR, patient accounting, and revenue cycle management systems.
• Utilize analytics and reporting tools to drive operational improvements and strategic decision-making.
• Champion data-driven performance management and accountability.

Leadership and Talent Development

• Lead, mentor, and develop high-performing revenue cycle leadership teams.
• Foster a culture of accountability, collaboration, excellence, and continuous improvement.
• Establish succession planning and leadership development strategies.
• Promote employee engagement and retention within revenue cycle operations.

Physician and Operational Partnerships

• Collaborate with physicians, clinical leaders, and operational executives to improve documentation, coding accuracy, throughput, and reimbursement.
• Enhance physician engagement in revenue cycle initiatives.
• Support patient-centered financial practices that improve the overall patient experience.

Key Performance Indicators (KPIs)

The SVP Revenue Cycle is accountable for performance in the following areas:

• Net Collection Rate
• Cash Collections
• Days in Accounts Receivable (A/R)
• Clean Claim Rate
• Initial Denial Rate
• Denial Recovery Rate
• Point-of-Service Collections
• Bad Debt Expense
• Charge Lag
• Coding Accuracy
• Patient Satisfaction Related to Billing
• Revenue Integrity Audits
• Employee Engagement and Retention

Qualifications/Requirements:

Experience:

Minimum of 15 years of progressive healthcare revenue cycle leadership experience.

Minimum of 10 years in senior executive leadership roles within an integrated healthcare system, academic medical center, or large multi-hospital organization.

Demonstrated success leading large-scale revenue cycle transformations and performance improvement initiatives.Experience managing complex reimbursement environments including Medicare, Medicaid, managed care, and value-based payment models.

Education:

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or related field.

Master's degree (MBA, MHA, MPH, or related discipline) required or strongly preferred.

Licenses / Certifications:

Other:

Special Requirements:

Physical Requirements:

Physical Activity (please check one box):

• Sedentary Work (involves sitting most of the time, occasionally walking and standing; requires lifting no more

than 10 pounds at a time and/or occasionally lifting or carrying objects)

☒ Light Work (involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects

weighing up to 10 pounds; requires moderate mobility to different work locations)