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Revenue Cycle Optimization Manager

Virginia Commonwealth University Health Systems
United States, Virginia, Richmond
Dec 24, 2024
The Revenue Cycle Optimization Manager is responsible for management and leadership of multiple complex priority initiatives to achieve operational efficiency, regulatory compliance, and revenue optimization supporting both hospital and physician revenue cycle performance. Define and maintain metrics, develop and implement improvement plans, evaluate and implement new technologies, and standardize policies and processes. Build positive relationships and lead through influence to create and support a system-wide strategy for revenue cycle optimization.

Essential Job Statements

  • Independently manage multiple complex revenue cycle optimization initiatives ensuring assignments remain within the constructs of time, scope, and budget.

  • Work collaboratively with leaders and stakeholders from across the organization to gain understanding of current revenue cycle operations from patient registration to claims submission and payment posting, to minimize errors and maximize revenue, recognize improvement opportunities, and implement sustainable solutions in an effective, cohesive, and comprehensive way. Prioritize process/workflow redesign as appropriate to increase efficiencies, reduce waste (denials and adjustments), limit variation and improve revenue cycle outcomes. Ensure changes to policies, processes, procedures, and technologies do not have an unintended negative impact to quality outcomes, patient experience or employee satisfaction.

  • Develop and monitor clearly defined leading and lagging indicators of revenue cycle performance to effectively track improvements while ensuring no adverse impact to operations. Work with stakeholders to define performance targets to achieve each fiscal year that ensure overall success of optimization initiatives and alignment with organization's strategic goals.

  • Work collaboratively with the operational leaders to ensure targets and goals are appropriately integrated and aligned with organizational priorities and desired outcomes. Promote strong cooperation and alignment across internal departments impacting revenue cycle operations, including Patient Access, Ambulatory Care, Clinical Departments, Managed Care & Contracting, Compliance, Regulatory, Risk Management, Information Technology, and others, as well as external vendors including Ensemble Health Partners and other revenue cycle support vendors.

  • Work effectively with analytics resources to develop effective and insightful dashboards and analytics to clearly illustrate and communicate success of optimization initiatives and achievement of targets and goals. Utilize advanced analytics to drive revenue cycle optimization work and to focus on highest priorities.

  • Serve as subject matter expert about revenue cycle optimization initiatives, remains aware of organizational changes that may impact initiative success, and continuously adapts and works with leaders to account for any impact resulting from these changes. Review existing revenue cycle processes and policies and provides input and recommendations for improvement. Monitor for compliance with continually changing federal, state, local, and industry requirements. Collaborate frequently with Compliance, Regulatory, Risk Management, Coding, and other departments related to revenue cycle compliance.

  • Effectively communicate to all levels of the organization about the purpose, goals, successes, and challenges of revenue cycle optimization initiatives.

  • Assist Director for Revenue Cycle Optimization and Vice President for Revenue Cycle Operations with developing and reporting annual strategic goals and objectives.

  • Attend meetings on behalf of and representing the Director for Revenue Cycle Optimization and Vice President for Revenue Cycle Operations when assigned.

  • Build, promote, and encourage a positive culture with team engagement, employee recognition and support to overcome hurdles.

  • Participate in various ad-hoc revenue cycle optimization initiatives as assigned.

Patient Population

Not applicable to this position.

Employment Qualifications

Required Education:

Bachelor's degree in related field or equivalent experience

Preferred Education:

Advanced Degree in related field

Licensure/Certification Required:

Licensure/Certification Preferred:

Certifications/registrations in functional area(s)

Minimum Qualifications

Years and Type of Required Experience

5 years revenue cycle operations/management experience

2 years performance improvement experience

Other Knowledge, Skills and Abilities Required:

Able to handle multiple priorities and adapt to frequent change.

Demonstrated ability to influence and guide other leaders without direct reporting authority.

Expert skills in MS Excel, Word, PowerPoint.

Strong working knowledge of Epic Hospital/Physician Billing.

Strong verbal/written communication skills.

Cultural Responsiveness

Demonstrates a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.

Other Knowledge, Skills and Abilities Preferred:

Diversity Equity and Inclusion certification preferred

Working Conditions

Periods of high stress and fluctuating workloads may occur.

General office environment.

May have periods of constant interruptions.

Physical Requirements

Physical Demands: Lifting/ Carrying (0-50 lbs.), Push/ Pull (0-50 lbs.), Stoop, Kneel, Squat

Work Position: Sitting, Walking, Standing

Additional Physical Requirements/ Hazards

Physical Requirements: Manual dexterity (eye/hand coordination), Repetitive arm/hand movements

Hazards:

Mental/Sensory -Emotional

Mental / Sensory: Strong Recall, Reasoning, Problem Solving, Hearing, Speak Clearly, Write Legibly, Reading, Logical Thinking

Emotional: Fast-paced environment, Able to Handle Multiple Priorities, Able to Adapt to Frequent Change

The Revenue Cycle Optimization Manager is responsible for management and leadership of multiple complex priority initiatives to achieve operational efficiency, regulatory compliance, and revenue optimization supporting both hospital and physician revenue cycle performance. Define and maintain metrics, develop and implement improvement plans, evaluate and implement new technologies, and standardize policies and processes. Build positive relationships and lead through influence to create a support a system-wide strategy for revenue cycle optimization.

Workday Day (United States of America)

EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.

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