Vice President, Clinical Revenue Cycle

Key Responsibilities

The Vice President (VP), Clinical Revenue Cycle provides strategic direction and oversight of the shared services revenue cycle operations for the Sutter Health System, including medical foundations and 27 hospitals. The VP will cover the core functions of: HIM, hospital and physician coding, utilization management (UM), and revenue integrity.

Qualification & Requirements

Education

Job Description:

• MA/MS in Healthcare or Business Administration, Accounting, Finance, or closely related field required, or equivalent education/experience.

Knowledge Required

• Must have a minimum of 5 years using Epic.
• Strong overall healthcare business knowledge/ insight.
• In-depth knowledge of hospital operations.
• In-depth knowledge of finance functional operations, systems and sub-systems, particularly in the area of healthcare revenue cycle applications including billing, accounts receivable (AR) and cash management, patient registration, professional services coding compliance regulations and requirements, managed care contractual terms and requirements, health insurance practices, industry regulatory requirements, business office operations, accounting, and industry standards for healthcare revenue resolution management practices. This knowledge should cover all areas of healthcare finance, including hospital, skilled nursing, physician, and ambulatory/ outpatient services.
• Strong knowledge of Finance/ AR-related healthcare and reporting technology.
• Advanced knowledge of Microsoft Suite – particularly Excel.
• Knowledge of key healthcare industry financial performance/statistical indicators.
• Knowledge of eliminating process complexities with an objective of performance improvement/ cost reduction.
• Deep understanding of developing a comprehensive/ compelling business case.
• Knowledge of effective communication vehicles and practical applications.
• In-depth awareness of all applicable rules, regulations, and standards, particularly including current Medicare and Medi-Cal compliance requirements.
• Comprehensive knowledge of healthcare coding compliance requirements.
• Familiarity with standard program/ project management tools and techniques.
• Awareness of cultural considerations.
• Understanding of principles behind creating Sourced and Shared Services.
• Knowledge of Change Management methodologies and techniques.
• Awareness of large performance improvement-related programs across Sutter Health.

Experience Required

• Significant experience managing all aspects of revenue cycle operations from initial patient contact through successful collection/ reporting outcomes.
• Seasoned professional management experience in the healthcare financial services field, with a work record that demonstrates leadership in alignment with the core values of the organization and proven negotiating skills.
• Significant experience in revenue cycle-related healthcare provider-based design and optimization, consulting, and project management.
• Experience reviewing and managing contracts, managing contractor/ vendor relationships, establishing service level agreements, and monitoring the delivery of services provided.
• Experience estimating costs/ benefits.

Experience Preferred

• Practical experience deploying Lean Six Sigma-based programs.
• Experience implementing large shared services or managing outsourced functions.
• Experience leading large-scale change efforts.
• Experience in implementing automated patient web portals allowing patients to schedule appointments, update information, and pay bills online.

Skills Required

• Financial management skills, including the ability to analyze financial data for operations, budgeting, auditing, forecasting, accounting, AR and reserve analysis, market analysis, staffing and financial reporting.
• Strong leadership skills to motivate cross-departmental teams’ performance towards excellence using team concepts and consensus-building management styles.
• Advanced/ effective interpersonal, written/ verbal communication and presentation skills, along with the ability to communicate complex finance concepts to others without a finance background.
• Demonstrated ability to engage in positive, powerful persuasion with individuals or groups with diverse opinions and/ or agendas, leading to outcomes that meet identified goals.
• Ability to analyze and resolve complex problems necessary to develop and administer multifaceted revenue cycle processes, regardless of whether issues originate in an area under direct or indirect control.
• Ability to enlist cooperation and build teams committed to carrying out initiatives in environments that may be resistant to change and not under the incumbent’s direct authority.
• Ability to translate key performance indicator levels into a finance-based business case, then design, implement, and manage more effective/ efficient processes.
• The ability to maintain a high level of positive energy/ creativity during periods of elevated work demands.
• Ability to function effectively as a team leader and member, engaging others as appropriate.
• Ability to prioritize multiple objectives in a rapidly changing environment and deliver quality outcomes.
• Advanced program/project management skills.
• Advanced skills in spreadsheet, project management, word processing and presentation software, preferably Microsoft Suite.
• Ability to develop and maintain effective relationships at all levels throughout the organization.

Benefits

• Insurance, Health & Wellness
• Financial & Retirement
• Family & Parenting
• Vacation & Time Off
• Other Perks & Benefits…