Vice President Mid-Revenue Cycle

Job Type: Regular

Time Type: Full time

Work Shift: Day (United States of America)

FLSA Status: Exempt

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.

The Vice President of Mid-Revenue Cycle is responsible for systemwide direction and leadership of operational, financial, programmatic and personnel activities for all Mid-Revenue Cycle areas. The Vice President of Mid-Revenue Cycle will be a collaborative, results-driven and data-oriented leader with a demonstrated track record of driving positive operational improvements within both academic and community health care provider settings. This individual will work effectively with other revenue cycle stakeholders to drive decision-making processes by performing detailed cost / benefit analysis, presenting and evaluating solution options, and building consensus among key stakeholders. The Vice President of Mid-Revenue Cycle will promote a culture that fosters a positive patient experience that focuses on patient safety and responsiveness to patient needs including timely access to care.

As a key revenue cycle leader, the Vice President Mid-Revenue Cycle is responsible for building and maintaining productive relationships with stakeholders across the organization including but not limited to Hospital and Clinical Senior Leadership, Health Information Technology, Managed Care Contracting, Health Information Management, Financial Operations, BILH Medical Group Operations, Harvard Medical Faculty Physicians, Legal, and Compliance.

Reporting to the Senior Vice President Revenue Cycle, this Vice President Mid-Revenue Cycle will work closely with Executive Leadership Teams, BILH SVP Revenue Cycle, revenue cycle teams and other leaders across the Beth Israel Lahey Health System. Direct reports titles to this position will include BIDMC CDI Director, LHMC/NHC/WIN CDI Director, CDI Community Manager, Health Information Management Operations Executive Director, and Coding Operations Director.

Job Description:

Essential Duties & Responsibilities including but not limited to:

The Vice President Mid-Revenue Cycle is responsible for all aspects of the mid-revenue cycle including the following functions:

• Revenue Integrity

• Health Information Management

• Professional and Technical Coding Operations

• Clinical Documentation Integrity

• Matrix leadership for related clinic services and physician practice support including working with clinical departments to support continuous improvement in revenue cycle operations.

• Serve as the lead executive for Mid-Revenue Cycle operations for BILH. Hold direct reports and employees accountable for meeting or exceeding quality standards and goals with continued improvement toward excellence in revenue cycle operations.

• Measure and monitor key performance metrics and deliver concise performance reporting to key stakeholders with corrective action plans for variances, as appropriate.

• Provide vision, drive, and leadership to develop, mentor, and unite Patient Access teams to deliver positive results.

• Supervise all patient access staff to recruit, motivate, develop, and retain a superior functional leadership team.

• Implement a management system that is outcomes-focused, encourages efficiency and automation, drives performance, and effectively develops and rewards key performers.

• Works closely with other BILH Revenue Cycle leaders to identify solutions for system optimization based on specified legal/compliance requirements/requests or planned changes in revenue cycle workflows.

• Maintain comprehensive policies, procedures, and documentation to validate revenue cycle procedures andrelated controls.

• Improve Revenue Cycle outcomes by overseeing RAC and regulatory audit tracking and review outcomes of audits to create targeted process improvement initiative and create internal controls.

• Collaborate with clinical documentation improvement, coding and operational expertise to identify and target opportunities for measuring and reporting company and physician outcomes.

• Monitor compliance with documentation standards to ensure physician records are complete and timely for compliance and billing, oversee physician notification for documentation deficiencies, delinquencies, and suspension.

• Works closely with the Information Governance team to address electronic health record maintenance, and forms management, record storage and destruction management.

• Oversee HIPAA Privacy for the Health System, manage HIM Privacy Officers and collaborate with Compliance to review and report privacy trends and risk assessments

• Promote compliance with federal and state laws as they relate to medical records and ensure that all health system policies and procedure are in accordance with the state and national requirements of CMS, HIPAA, Medical Staff Bylaws, Rules and Regulations and, all other regulatory agencies

• Responsible for BILH health information management operations, including but not limited to, HIM functions, processing of birth certificate/ paternity papers, record reconciliation, medical staff and hardcopy retrieval of medical records

• Communicate and educate leadership regarding patient access operations and integrate facilities, physician practices, and joint ventures into the revenue cycle organization, as directed by executive leadership.

• Oversee the implementation of any software applications or technology enablers that improve the overallfunctionality of the revenue cycle.

• Coordinate with Compliance to validate compliance with any governmental or other payor program that may impact revenue cycle operations.

• Leverage knowledge of both hospital and physician office operations to identify "cause-and-effect" scenarios that impact the effectiveness of the receivables management process along with a thorough understanding of revenue cycle operations.

• Oversee development of Mid-Revenue Cycle reporting metrics and directs efforts to monitor, assess and ensure the ongoing feasibility of such metrics to ensure continued alignment of policies and process against industry best practices.

• Develop, maintain, communicate, deploy, and ensure execution of standard policies and procedures where necessary to drive standardization system wide, seeking proper input and approvals from key internal stakeholders prior to deployment.

• Effectively manage Mid-Revenue Cycle vendor partners to ensure performance service levels are met.

• Responsible for the overall financial budgets and expense management for all Mid-Revenue Cycle areas.

Qualifications :

Education:

Bachelor's degree in Accounting, Finance, Economics, Business or a related field required.

MBA or master's degree related field highly preferred.

Licensure, Certification & Registration:

Experience with EPIC Revenue Cycle Applications is preferred in addition to RHIA and RHIT certifications or related experience.

Experience:

• Requires a minimum of eight years' working in increasingly complex and strategic revenue cycle operations increasingly complex and strategic revenue cycle operations and patient financial leadership with 3-5 years of experience at the Vice President level or above.

• 5+ years of experience in a complex, multi-site, highly matrixed healthcare system experience in an academic medical center or major teaching hospital is preferred; relevant consulting and for-profit healthcare experience will also be considered.

• Demonstrated knowledge of healthcare accounts receivable management concepts such as State and Federal regulatory environments, governmental program guidelines, HCPCS, ICD, CPT's, Revenue Codes, DRG and reimbursement methodologies, including governmental and private payer.

• Experience leading related teams with a service-oriented culture and patient financial leadership with 3-5 years of experience at the Vice President level or above.

• 5+ years of experience in a complex, multi-site, highly matrixed healthcare system experience in an academic medical center or major teaching hospital is preferred; relevant consulting and for-profit healthcare experience will also be considered.

• Demonstrated knowledge of healthcare accounts receivable management concepts such as State and Federal regulatory environments, governmental program guidelines, HCPCS, ICD, CPT's, Revenue Codes, DRG and reimbursement methodologies, including governmental and private payer.

• Experience leading related teams with a service-oriented culture

Skills, Knowledge & Abilities:

Driving Results

• Works to achieve goals while overcoming obstacles and/or planning for contingencies.

• Shows strong feelings (e.g., urgency) about reaching targets.

• Checks work of self and others against required quality standards.

• Reviews performance and progress on a regular basis to ensure team is achieving results.

• Tests to see if goals are sufficiently challenging and implements corrective action based on deviations.

Collaborating and Influencing

• Invites and uses the opinions and perspectives of others.

• Engages people in a dialogue to gain commitment and bring them "on board", linking their perspective to the intent.

• Adapts own approach to the audience, anticipating impact of words and actions, preparing for possible resistance and responding in an appropriate style, using a range of influencing styles.

• Resolves conflicts by discussing individual issues with each person.

• Checks with both sides of a discussion to ensure a common understanding.

• Takes initiative to maintain contacts.

Other Personal Characteristics

• A self-starter who is intellectually curious, innovative, and excited about "creating" in a fast-paced environment.

• Superior communication skills, both written and verbal; expert at translating and communicating complex financial and operational information to varying audiences.

• Ability to work in a highly-matrixed environment, and to receive direction from and build consensus with multiple sources.

• Strong emotional intelligence. A balance of wisdom and judgment with an ability to work independently with little direction.

• Demonstrated skill in navigating successfully through ambiguity and frequent change - agile and flexible as a leader, peer, coach and team member.

• Strategic and future-oriented, with a tangible, demonstrated, robust commitment to the mission and growth strategies of BILH.The instinct to be politically astute, yet not political.

• The highest personal integrity and ethics.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (~~~) about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

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