At Children’s, the region’s only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are supported and deeply valued. Opportunities for career growth abound as we grow our services and spaces, including the cutting-edge Hubbard Center for Children. Join our highly engaged, caring team—and join us in providing brighter, healthier tomorrows for the children we serve.

Children's is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.

A Brief Overview
The Director is responsible for revenue cycle operations for all hospital, professional, and home health services for the Organization and its affiliated entities. Leads patient billing, insurance claims, collections, denials, cash posting, and customer service to optimize financial performance and ensure regulatory compliance. Key responsibilities include leading and developing staff, developing strategies for financial performance, implementing policies and procedures for efficiency, analyzing financial data, collaborating with stakeholders, and improving the patient financial experience. Achieving revenue cycle performance objectives and organization strategic goals will require focus on key metrics, strong leadership, financial acumen, and healthcare industry expertise.

Essential Functions

• Analyze performance, identify opportunities, and lead execution on initiatives to improve performance on key metrics including cash collections, AR days, denial reduction, administration adjustments, and individual team productivity goals.
  • Prioritizes operational initiatives based on analysis of current processes and organizational goals.
  • Evaluates, identifies and implements opportunities for increased automation of revenue cycle operations through optimization of Epic functionality and/or other integrated system solutions.
  • Build relationships for effective collaboration with departments (IT, finance, managed care, revenue integrity, reporting, etc.) to meet defined goals.
  • Applies continuous process improvement principles (Lean, Six Sigma, etc.) to enhance and standardize workflow processes to achieve efficiency and consistency in revenue cycle performance and optimize AR management.
• Serves as revenue cycle subject matter expert regarding trends, best practices and innovations and identifies opportunities for their application.
  • Develops, recommends and executes revenue cycle strategies that support the organization’s strategic plan in alignment with Chief Revenue Officer and based upon input from key stakeholders.
  • Serves as a revenue cycle expert to the Organization and presents revenue cycle information to executives, physicians, and key leaders.
  • Evaluates and identifies strategic system implementation goals for capital budgeting and system implementation timelines.
• Lead, coach, and develop teams of managers, supervisors, and staff, fostering an environment of continuous improvement and a positive work environment.
• Evaluates the effectiveness of and monitors the implementation and enforcement of policies, practices and procedures to maximize customer focus, efficiency and effectiveness of revenue cycle department(s) while achieving identified standards.
• Collaborates effectively on strategies and initiatives for revenue enhancement through coordinated efforts with managed care, reporting, and revenue integrity teams. These efforts may be related to evaluating and reacting to payor performance, charging strategies, and projects with clinical teams to optimize charging and collections.
• Leads the development of the patient financial services department(s) budget to assure that budget expectations and program needs are met through appropriate resource allocation. Prepares budget variance reports and develops corrective strategies to meet the area’s operational or financial plan.
• Collaborates with legal counsel, payers and other interested third parties to resolve claim payment disputes, payment variances, medical management policy issues and contractual disputes.

Education Qualifications

• Bachelor's Degree from an accredited college or university in healthcare administration, business, accounting, finance or related field including advanced study or in-depth knowledge of specialized business, finance and healthcare principles Required or
• Master's Degree in related field of study preferred

Experience Qualifications

• Minimum of 5 years of revenue cycle management leadership experience in a hospital required
• Minimum of 8 years of healthcare experience required 
• Prior work experience with Epic revenue cycle applications required

Skills and Abilities

• Knowledge of hospital operations, billing, collection and reimbursement requirements and standard practices.
• Ability to review, interpret and implement managed care contracts with third-party including governmental payers.
• Foster creativity, innovation and divergent thinking in self and others.
• Ability to communicate effectively both verbally and in writing to individuals and groups in a variety of settings.
• Critical thinking, strategic and project management skills.
• Ability to effectively implement change.
• Patient financial experience focus.
• Ability to effectively communicate, verbally, in writing and formal presentations, with individuals at all levels in the organization.

Licenses and Certifications

• EPIC - EPIC Certification in revenue cycle modules Preferred

Children’s is the very best for kids and the very best for your career! At Children’s, we put YOU first so together, we can improve the life of every child!

IND123