Market Director of Revenue Cycle NV

As the community’s only not-for-profit faith-based healthcare system; Dignity Health Nevada has been guided by the vision and core values of the Adrian Dominican Sisters for more than 70 years. As the Henderson and Las Vegas communities grow Dignity Health-St. Rose Dominican facilities and its more than 3400 employees will continue the Sisters’ mission of serving people in need. St. Rose Dominican is a member of Dignity Health one of the nation’s largest healthcare systems a 22-state network of more than 9000 physicians 60000 employees and 400 care centers including hospitals urgent and occupational care imaging and surgery centers home health and primary care clinics. Headquartered in San Francisco Dignity Health is dedicated to providing compassionate high-quality and affordable patient-centered care with special attention to the poor and underserved. You can also follow us on Twitter and Facebook.

Job Summary:

The Market Director of Revenue Cycle reports directly to the Region Vice President of Revenue Cycle and works collaboratively with Market and Region stakeholders to develop revenue cycle strategies and develop integration and implementation plans for the assigned market(s). The position is responsible for ensuring optimal revenue operations across the market(s) of responsibility by driving revenue cycle opportunity identification, project management, vendor
accountability, performance tracking, and partnership between clinical, operational, and financial stakeholders and departments.
The Market Director of Revenue Cycle is responsible for the working in conjunction with internal and external (herein known as Vendor) teams on the coordination of the Revenue Cycle Department consistent with the vendor’s scope of
work, as well as maintaining current accounts receivable records to ensure cash position and other detailed requirements are compliant throughout the organization as it relates to Billing and collecting. Coordinates with IT, CI team, and EHR system to optimize revenue cycle operations by solving technology/build issues, interface issues, and work flow/process issues that prevent efficient and effective patient billing, coding, and payment of claims. Leads and directs a wide variety of work queue and process oriented teams that encompass staff from CommonSpirit and Vendor. Responsible for planning, directing, coordinating and evaluating the operations and services of multiple departments that are responsible for the hospital revenue cycle for the assigned market in accordance with overall business objectives, professional standards, and applicable regulatory requirements. Provide daily management, mentoring and oversight for the Revenue Cycle Administration team.

Job Responsibilities:

• Manages and evaluates the operations/services of the assigned function, acute revenue cycle to ensure that all activities are conducted in a timely and cost-effective manner and in accordance with organizational values, professional standards, internal policies/standards/procedures and/or applicable regulatory requirements
• Monitor revenue cycle and other executive dashboards to identify any performance deficiencies within the assigned market; drive systemic feedback for corrective action throughout the market. Reviews operations data, budgets, audits, forecasts, accounts receivable, third party billing and collection processes to improve operational performance and to align with industry best practice
• Responsible for the Hospital-wide denial management program. This requires cooperation and shared responsibilities with the Vendor team. Develop and implement denial tracking, trending and root cause analysis reports. In collaboration with all hospital departments work as a team to reduce and prevent denials. In conjunction with Payer Strategy work with third party payers to address denials and assure compliance with current payer contracts. Complete Post Payment analysis and escalate variances to payers as appropriate.
• In conjunction with Vendor, responsible for all revenue cycle functions including patient access, system billing,reporting and support.
• Enforce performance, accountability, and communication standards with Revenue Cycle vendors.
• Function as liaison between Revenue Cycle partners/vendors, Finance, Revenue Generating Departments, and Compliance Departments for patient experience and revenue related issues and resolutions.
• Oversight of preparation and maintenance of Medicare Bad Debt Log and Medicare Part A and traditional Medicaid
  enrollment/revalidation.
• Coordinates meetings with revenue cycle, clinical, IT, and financial key stakeholders to analyze, map, understand the revenue cycle billing system in order to plan and implement changes, to correct processes and gather the right
  resources to remedy issues.
• Keeps VP of Finance & Chief Financial Officer informed of the status of the Revenue Cycle Department.

Minimum:

Education:

Bachelor’s Degree in related discipline

Master’s Degree strongly preferred

Experience:

• Experience with third party claim resolution processes including denials and appeals management, adjudication of claims required
• 3+ years of acute care experience in hospital setting preferred
• Knowledge of ICD-10 methodology

Knowledge/Skills:

• Language Ability: Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to sensitive inquiries or complaints from customers, regulatory agencies, or members of the business community. Excellent written, oral and interpersonal communication skills to educate and interact with all levels of healthcare professionals.
• Math Ability: Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra
• Reasoning Ability: Ability to define problems, collect data, establish facts, and draw valid conclusions. Must be a strategic thinker and insightful decision maker with ability to analyze and solve problems and have demonstrated leadership skills including the ability to direct changes to existing routines or practices to meet changing organizational needs.
• Computer Skills: Must be proficient in Microsoft Office software, including Excel. Must also be able to use vendor-based Internet software and have previous experience with databases.