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VP, Revenue Cycle Management
BAYADA Home Health Care
Pennsauken, NJ
Posted 6/5/2024
Job Description:
BAYADA Home Health Care has an exciting opportunity to join our senior leadership team as Vice President, Revenue Cycle Management. At BAYADA, we are led by the mission, vision and core values of The BAYADA Way. We believe that our clients and their families deserve home health care delivered with compassion, excellence, and reliability. If you are seeking an extraordinary leadership opportunity in a values driven organization, this may be the role for you!
The VP of Revenue Cycle Management (also referred to internally as ‘Division Director’) leads all functions that contribute to the capture, management, and collection of revenue for BAYADA Home Health Care. This role will provide oversight and direction of all revenue cycle services ensuring that all processes are appropriately managed in accordance with company standards and federal and state regulatory requirements. In addition, the VP of Revenue Cycle Management will develop professional relationships with operating leaders to instruct, share ideas and implement actions for the effective optimization of efficient workflow and industry leading outcomes. Furthermore, this position will provide ongoing support to professional staff, lead through RCM expertise, contribute strategic planning acumen, and create a culture aligned to company values and purpose.
The successful candidate brings 15+ years senior leadership experience in healthcare revenue cycle management across large, multi-faceted organizations. Ability to think strategically, innovate, and transform systems and processes to support regulatory and industry changes. This is a hybrid position with required onsite interaction in Pennsauken, NJ on a consistent basis.
Primary Responsibilities:
- Ensure successful operations for revenue cycle functions at the enterprise level, across multiple business practices, states, and payors (primarily Medicare, Medicaid, and commercial insurances).
- Directing and managing key vendor relationships across the revenue cycle spectrum.
- Ability to prioritize effectively across competing priorities for self, team, and external partners.
- Lead evaluation and integration of revenue cycle functions for acquisitions and joint venture businesses, including legacy accounts receivables.
- Continuous directing and evaluating of processes, systems, and models to implement changes to policies, procedures, and technology as appropriate.
- Ensure adherence to existing and new regulatory requirements that impact revenue cycle operations, including partnership with other functional teams to ensure adherence.
- Develop, execute, and manage key strategies through multiple levels of leadership and management teams, fostering an environment of accountability that creates high performance.
- Provide analysis, reporting, monitoring, and recommendations for operational performance in key metrics.
- Facilitate structured reporting cadences to create visibility into results and the development of strategic and tactical plans to optimize results.
- Direct and liaise with internal and external payor relations representatives regarding accounts receivable matters and administrative efforts with revenue cycle.
- Collaborate with internal stakeholders to ensure revenue optimization and realization.
- Communicate effectively through verbal and written methodology.
- Proactive review and response to market dynamics associated with reimbursement models.
- Research, assess, and direct the implementation of new technology innovation across multiple practice lines and functions that prevents workflow friction and maximizes automation.
- Motivates and leads a high-performing team; attracts, recruits and retains required members of revenue cycle team to drive continuous improvement and strong internal personal relationships.
- Manage external resource partnerships through contractual SLAs and operational performance management that supports the operations and outcomes for the revenue cycle teams.
Leadership competencies:
Strategic leadership and vision – ability to develop and articulate comprehensive vision for strategic objectives and long-term strategies that aligns with industry trends, regulatory changes and emerging technologies.
Team development – cultivate a strong culture of connection and value-orientation that promotes team unity, alignment towards the mission and performance-driven focus.
Stakeholder engagement – forge strong partnerships with practice leaders, functional leaders and other key stakeholders across the organization promoting collaboration and operational change management.
Innovative mindset – evaluate, select and implement cutting-edge technology solutions to enhance revenue cycle processes and reduction in denials and bad debt. Lead implementation of RCM systems, artificial intelligence tools and automation platforms.
Compliance and risk mitigation – Maintain an enterprise lens of complex healthcare regulations, including Medicare, Medicaid and commercial payor guidelines. Develop compliance programs and internal controls to mitigate risk.
Executive reporting and performance metrics – develop comprehensive dashboards and executive-level reports to communicate KPIs, trends and financial outcomes to stakeholders, RCM teams and senior leadership.
Thought leadership – Serve as a thought leader and SME in denial management, revenue cycle optimization and emerging technologies. Be an active participant in professional associations and internal committees.
Qualifications:
Education – Bachelor’s Degree required.
Experience – at least 15 years of demonstrated leadership experience, with at least 10 years of experience within healthcare revenue cycle management preferred. Intake, Authorization management, medical billing and accounts receivable management experience required. Strong experience with home health care services is preferred. Strong knowledge of health insurance plans and operating within a multi-state and federally regulatory environment.
Benefits:
BAYADA believes that our employees are our greatest asset: BAYADA offers a comprehensive benefits plan that includes the following: Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with company match, direct deposit and employee assistance program.
Apply:
https://jobs.bayada.com/en/jobs/7473336002/vp-revenue-cycle-management-healthcare/?gh_jid=7473336002
Manager, Revenue Integrity
AtlantiCare
Egg Harbor Township, NJ
Full-time
Posted 4/4/2024
Job Description:
Manager, Revenue Integrity Full Time Egg Harbor Township, New Jersey AtlantiCare, the largest healthcare organization in southeastern New Jersey, is seeking a Manager, Revenue Integrity to join our growing team.
The Manager of Revenue Integrity will provide daily oversight and leadership to the Revenue Integrity team, which includes all payer audits, the Charge Description Master (CDM), charge capture processes, clinical denial appeals, OPPS Medicare claim edits and development of the Billing Determination Forms for clinical research studies. This role will include hands-on work in the review of claims held due to coding or charge edits, review of clinical documentation, identification of corrections needed to get a claim billed and paid correctly, assistance with clinical appeals and backing up all areas of responsibilities. This position will collaborate regularly with the Patient Accounting team related to clinical questions on claims with the Finance team related to charge volume questions and with various clinical leaders and staff related to the correct documentation needed to support charges and/or Medicare coverage determination rules. The position requires a high level of problem-solving skill, the ability to work independently, the organizational skills to manage multiple things at once, and the ability to effectively manage a group of highly experienced employees with diverse responsibilities. Strong computer and research skills are essential.
QUALIFICATIONS:
Education:
- Graduate of an accredited school of nursing as a registered nurse. • Bachelor’s degree in Nursing or related field (can be in pursuit of the degree).
License/Certification:
- Current NJ license as a registered nurse is required. • Certification in hospital outpatient coding (COC) is preferred.
Experience:
- 3-5 years of experience in a leadership role is required, ideally in revenue integrity functions.
- 2-3 years of experience working with CPT, HCPCS and UB codes is required.
- Experience working with CDM maintenance, appeal work and billing and clinical documentation systems is strongly preferred.
- Knowledge of the inter-relation between charging, coding and billing is required.
- The ability to communicate effectively with clinical and non-clinical staff and leaders is required.
PERFORMANCE EXPECTATIONS:
- Demonstrates the competencies as established by the department and on the Assessment and Evaluation Tool for this position.
WORK ENVIRONMENT:
- This position requires desk/computer work a majority of the time. Essential functions of this position are listed in the Assessment and Evaluation Tool.
REPORTING RELATIONSHIP:
- This position will report to the Director of Revenue Integrity & Utilization Management. It directly supervises the PFS Medical Audit Supervisor, the Charge Description Master Supervisor, a Revenue Integrity Nurse Auditor and a Clinical Denial Appeal Nurse, as well as having indirect supervision of the Medical Audit Assistant.
The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.
For more information, contact the recruiter: Rebecca Leeds at [email protected] 609-389-2273
Equal Opportunity Employer. M/F/D/V.