Vice President – Revenue Cycle

SUMMARY
Reporting to the VP of Finance of Eastern Maine Healthcare Systems, this position is responsible for providing leadership for all activities related to the management of Northern Light Health’s largest asset, its revenue cycle. The Vice President of Revenue Cycle sets the strategic direction for all of Northern Light Health’s hospitals, affiliates, and physician services for all Revenue Cycle functions. Revenue Cycle functional areas that report to this position include; Patient Access (on-site and centralized functions), Health Information Management, Patient Financial Services, Revenue Integrity, and Revenue Cycle Business Support, for assigned facilities, both with the hospitals and physician practices.

PRIMARY RESPONSIBILITIES / DUTIES

Setting the strategic direction for the Northern Light Health Revenue Cycle function
Managing the Revenue Cycle operations for all of Northern Light Health
Meeting and exceeding the organization’s cash requirements
Managing the receivables in a prudent manner so as to optimize its net realizable value
Providing world-class service to customers that continually exceeds their expectations and is in-line with Northern Light Health’ mission and values
Serve as the spokesperson for Northern Light Healthto internal and external organizations, including governmental agencies, board members, payor organizations and auditors
Provide strategic vision, challenging assumptions and standards of business

Budget Responsibility
Administers expense budget for departments
Presents departmental budget recommendations to VP of Finance for approval
Monitors budget performance and variance explanations
Optimizes vendor relationships
Plans for capital expenditures
Evaluates current and new technology solutions

Authority / Decision Making Level
Prioritizes and organizes work within division to meet changing priorities
Approves account adjustments, refund requests, and bad debt placements for accounts over specified threshold; forwards all adjustments requests greater specified threshold to VP of Finance for approval
Reviews and approves policies and procedures for the revenue cycle department for the hospitals as well as the related policies and procedures for the physician practices

Supervisory Responsibility
Directs activities of staff Directors and Managers that oversee all aspects of the Revenue Cycle
Provides leadership to direct reports and develops them into strategic thinkers and leaders across the organization
Manages direct reports and has responsibility for hiring, firing, performance management and results of the assigned area
Authorizes PEP requests for direct reports
Approves initiation of disciplinary proceedings for staff, in consultation with Human Resources

Leadership
Provides strategic vision and direction to effectively manage industry shifts, regulatory changes, and rising cost pressures relating to revenue cycle functions
Evaluates, monitors and assists in developing the priorities and progress of the Revenue Cycle Department
Provides senior leadership with information regarding receivable and/or departmental performance
Through management and staff, implements improvements in work process that both improve the efficiency and effectiveness of the revenue cycle
Leads redesign initiatives and other Northern Light Health-sponsored initiatives as requested

Designs easily understood and impactful managerial reports for wide distribution
Works with management staff, monitors payer and vendor activities and communications
Stresses attention to detail and designs monitoring tools to ensure accuracy
Identifies opportunities for improved efficiency through better processes and additional automation. Monitors impact of process-oriented changes on staffing requirements
Coordinates and collaborates with key functions outside of Revenue Cycle to ensure strategic alignment with broader organizational goals and objectives
Serves as an organizational sponsor for implementation of any software applications or technology enablers that improve the overall functionality of the Revenue Cycle. This may include installation of new bill editing software, insurance eligibility tools, coding tools, financial screening tools, an automated secondary billing application, automated payment and rejection posting routines, or enhancements to the mainframe applications
Functions effectively in a Matrix Management environment

People
Leads strategically through empowering staff and developing direct reports
Demonstrates leadership and commitment to staff and colleagues by accepting accountability for outcomes, sharing timely information, building effective relationships and communicating clearly and directly
Ensures adequate training is being provided to staff to educate on the following skills: current working knowledge of payer requirements; sufficient healthcare knowledge necessary to perform job requirements; knowledge of state, local and federal policy requirements for functions performed; and relevant knowledge of information technologies
Leads and coordinates ongoing staff evaluation, retention, training and management of policies and procedures
Manages and oversees staff performance through performance planning, coaching and performance appraisals

Process

Demonstrates leadership and commitment to staff and colleagues by accepting accountability for outcomes, sharing timely information, building effective relationships and communicating clearly and directly
Develops, implements, and manages efficient and effective operational policies, processes and performance monitoring across all functions of the Revenue Cycle Department
Ensures Revenue Cycle staff across all functions comply with established policies, processes, and quality assurance programs
Works with various Revenue Cycle stakeholders, state agencies, government agencies and third-party payers to ensure timely and appropriate resolution of acute care accounts receivable
Responsible for ensuring two-way communication with Revenue Cycle and hospital leadership

Provides ongoing feedback loop communication to clinical areas, front-end, mid-cycle, and back-end Revenue Cycle functional areas
Develops, implements, and manages efficient and effective operational policies, processes and performance monitoring across all Revenue Cycle functions
Routinely coordinates payor trend analysis to ensure optimal processing and reimbursement, identify issues, communicate findings to Revenue Cycle stakeholders, define solutions and initiate resolution
Works closely with Managed Care Contracting group to resolve payer disputes and advise on contract terms

Performance Monitoring
Measures and reports ongoing financial and operational performance of the Revenue Cycle department. Recognizes areas of excellence and oversee the development and implement action plans related to functional areas where performance is not meeting expectations
Manages/communicates the department dashboard and design action plans as issues are identified within the unit
Ensures that key performance metrics are met on a monthly basis

QUALIFICATIONS

Education and Experience

Knowledge
Significant understanding of healthcare business and finance principles related to all functions of the Revenue Cycle
Demonstrated knowledge of healthcare management, registration, billing and collection processes

Demonstrated knowledge of payer reimbursement regulations and coding requirements
Strong organizational skills, working effectively in a multi-task environment
Demonstrated proficiency in written and verbal communication skills
Demonstrated ability in leadership
Ability to relate cooperatively and constructively with clients, co-workers, administration, other clinic departments, providers, community agencies, and other health team members
Ability to work in a fast paced environment and remain flexible under stressful situations