Director, Denials Prevention & Performance Improvement
About The Position
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The Director, Denials Prevention & Performance Improvement leads the enterprise-wide strategy for reducing denials, improving upstream workflows, and driving systemic performance improvement across all Revenue Cycle functions. This role oversees denial analytics, cross-functional remediation efforts, clinical and operational partnerships, and digital enablement strategies to strengthen financial outcomes and reduce revenue leakage. The Director aligns facility-specific needs with enterprise priorities and ensures visibility, accountability, and measurable operational improvement across Beth Israel Lahey Health (BILH).
Requirements
- Bachelor’s degree required; Master’s degree preferred.
- 5-8 years’ demonstrated experience leading Revenue Cycle performance improvement initiatives in a complex health system.
- Deep knowledge of hospital and professional billing workflows and denial prevention best practices.
- Strong analytical abilities with capacity to synthesize complex data into actionable strategies.
- Ability to influence physicians, clinical leaders, and operational stakeholders without direct authority.
- Executive presence and strong communication skills for presenting complex issues to senior leadership.
- Strong understanding of clinical, technical, and payer-related denial drivers and upstream workflow dependencies.
Nice To Haves
- Working knowledge of Epic Revenue Cycle applications and reporting infrastructure preferred.
Responsibilities
- Lead the development and execution of an enterprise denials prevention strategy across hospital and professional billing environments.
- Analyze clinical, technical, and payer-related denial trends to identify root causes and drive upstream corrective actions.
- Partner with Clinical Revenue Cycle, Physician Advisors, and clinical departments to address documentation, medical necessity, and coding-related denial drivers.
- Collaborate with Access & Experience to mitigate front-end authorization and eligibility denials.
- Coordinate with Patient Financial Services to understand denial patterns, payer-specific issues, and system-level trends.
- Establish enterprise standards for denial categorization, tracking, reporting, and root cause identification.
- Lead structured performance improvement initiatives using disciplined problem-solving methodologies.
- Oversee Revenue Cycle digital and automation strategy to enhance work queues, workflows, and system configuration.
- Deploy technology-enabled solutions (automation, reporting enhancements, workflow redesign) to strengthen productivity and reduce manual effort.
- Monitor initiative ROI and ensure measurable improvements in denial rate, net revenue yield, and AR performance.
- Partner with Revenue Cycle Business Partners and PFS Denial Recovery lead to prioritize facility-specific interventions based on performance trends.
- Collaborate with Enabling Services (Reporting & Analytics) to enhance dashboards and KPI visibility for operational and clinical leaders.
- Maintain current knowledge of regulatory requirements, payer rules, industry trends, and emerging technologies to inform strategic planning.
- Elevate systemic risks and opportunities to Revenue Cycle and Executive Financial Leadership.
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What This Job Offers
Job Type
Full-time
Career Level
Director
Number of Employees
251-500 employees
