Description
THE ROLE
Reporting to the Executive Vice President, Chief Revenue and Growth Officer, the Chief Revenue Cycle Officer position is critical to the delivering on Providence’s strategic vision, Destination Health. The role of the CRCO is to deliver world class, high performing revenue cycle operations while ensuring that Providence is a destination for top talent. Working in conjunction with clinical and non-clinical staff, the CRCO will manage the day-to-day operations on all processes related to the revenue cycle functions. The leader will cultivate teams and partnerships that reduce the administrative burden for our patients, our communities, and our caregivers. The CRCO will do this through deploying an operating model that leverages Providence assets and capabilities with an eye towards simplification and innovation. This includes infusing technological innovation into the revenue cycle and building towards an industry leading capability.
In support of the system-wide goals, the Chief Revenue Cycle Officer directs and implements PSJH’s financial plans and strategies associated with revenue realization. The role includes supervision of revenue cycle operations for hospital and physician services, including in-house and vendor management. These include pre-service activities such as scheduling, registration, insurance verification, and authorization management; the position is also responsible for traditional Mid Revenue Cycle and Revenue Integrity functions related to the maintenance of the charge description master, coordination with coding and billing efforts throughout the organization, and third party cost report preparation; finally, all back-end collections (including denials and escalation), posting and reconciliation efforts are in scope. The CRCO participates actively in strategic and business unit planning to develop reasonable and thorough revenue projections for annual budgets and multi-year projections. The leader participates actively in third party contract negotiations and negotiates with governmental payers as required. Critical responsibilities include achievement of annual and periodic goals for significant indicators of revenue cycle performance and for the organization's overall financial performance.
The ideal candidate will be an accomplished healthcare executive with depth of leadership in overseeing acute and physician revenue cycle activities, with strong operational and strategic leadership for advancing the financial performance of a large ambulatory organization.
Ideal Qualifications
- Bachelor’s degree required preferably in business, health or public administration or management. A Master’s degree is preferred
- Fifteen years of management experience in revenue cycle work, with another five years at the management level from a multi-facility system
- In-depth knowledge of hospital and physician billing and reimbursement required
- CPA certification is a plus
- Broad view of the revenue cycle. The Chief Revenue Cycle Officer must not only be a subject matter expert in billing and collections, but also many other connected areas. This includes innovation within the patient registration process, improving the ease and accuracy of patient coding in alignment with increasingly sophisticated regulatory standards, integration with insurance/managed care contracting, and innovation regarding working proactively with patients who have high deductible health plans
- Strategic understanding of the utilization of technology . The CRCO executive must have curiosity for the changing technology landscape with an eye towards optimizing workflow and streamlining the caregiver and patient experience.
- A bility to communicate and work with other key leaders and staff . The CRCO must be a proven leader who works across functional areas inside and outside of RCM to deliver on the goals of the organization. As the CRCO this includes working with Supply Chain, Managed care, Clinical Care, Strategic Partners and Finance functions among others
- Direct all aspects of the revenue cycle. Responsible for monitoring an efficient and effective revenue cycle designed to maximize revenues while adhering to compliance policies and procedures
- Implement and nurture a culture of continuous process improvement and quality assurance to promote innovation
- Sponsorship and oversight of collaborative vendor management function that works to manage cost and performance elements of all revenue cycle vendor relationships
- Oversight of backlogs, denials and collections, and up-to-date training for coders and billers
- Experience in payment and reimbursement systems and methodologies for large, complex hospitals, physicians and/or MCO’s required
- Maintain currency with Medicare and Medicaid regulations for billable and non-billable services
- Expertise working knowledge of patient registration, billing, A/R, cash management requirements
- Development, execution and maintenance of a plan to improve revenue cycle
- Analyze and resolve problems that affect the claim submission process
- Financially analyze data for operations, budgeting, auditing and forecasting
- Motivate team’s performance toward excellence in a cross-departmental organizational structure
- Must have the ability to understand, apply and analyze computerized accounting and information systems. Must have the ability to supervise others and maintain cooperative relationships
- Provide month end reports including collections, AR, denials, and backlogs
- Work closely with the CFO and operations leadership for revenue enhancement activities
- Assess and work with billing packages and recommend changes if necessary
- Must be able to read, analyze, and interpret the most complex documents. Able to respond effectively to the most sensitive inquiries or complaints
- Finally, a desire to lead a large and diverse organization of individuals with varying degrees of training, experience and knowledge of healthcare and revenue cycle.
- When it comes to healthcare administrators, focused analysis combined with the ability to see the big strategic picture is key.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
Requsition ID: 122131
Company: Not Applicable
Job Category: Revenue Cycle Operations
Job Function: Revenue Cycle
Schedule: Full time
Shift: Day
Career Track: Leadership
Department: 4015 SS SYS FIN 1
Address: WA Renton 1801 Lind Ave SW
Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.