Director Managed Care & Payment Integrity
About The Position
Norman Regional Health System (NRHS) is seeking an experienced revenue cycle executive to serve as its Administrative Director of Revenue Cycle Management & Managed Care. This is a full-time, on-site leadership position responsible for the strategy, performance, and day-to-day operation of the organization’s end-to-end revenue cycle across Hospital Billing (HB), Professional Billing (PB), and Ambulatory Services enterprises. This role will provide unified leadership over Revenue Optimization (Utilization Review & Charge Integrity), Patient Financial Services (Billing & Collections) and Managed Care (Payer Contracting & Relations). This role teams will organize teams around the revenue cycle continuum with clear ownership, accountability, and cross-department collaboration. The Administrative Director will drive net-revenue performance, accelerate cash collections, minimize avoidable write-offs, and maintain compliance, while building a data-driven, prevention-focused operating model. The ideal candidate is a health-system revenue cycle leader with successful experience across front-end, middle, and back-end revenue functions, with strong financial and analytical acumen, and an executive presence to represent revenue cycle to the CFO, Executive Team, and Board.
Requirements
- 10+ years of revenue cycle experience in a healthcare setting, including 5+ years at a director or higher level of leadership with oversight of multiple end-to-end functions across healthcare organizations with multiple service lines.
- Demonstrated results in net-revenue improvement, cash acceleration, denials reduction, and cost-to-collect performance in a hospital or health system setting.
- Experience leading and developing management teams with successful coordination and collaboration across internal and external stakeholder groups.
- Strong command of revenue cycle KPIs, analytics, and reporting, with a data-driven approach to decision making.
- Working knowledge across hospital, physician and ambulatory billing and reimbursement models, coding/CDI, charge integrity, billing, A/R, denials, and payer contracting concepts.
- Executive presence with the ability to synthesize complex information into clear recommendations for the CFO, Executive Team, and Board.
- Bachelor’s degree in Business, Healthcare Administration, Finance, or related field.
Nice To Haves
- Master’s degree (MBA / MHA) and relevant certifications (e.g., CRCR, CHFP, CPC/CCS, or comparable).
- Experience with Meditech and common revenue cycle / analytics platforms (e.g., FinThrive, VisiQuate, 3M).
- Experience in the Oklahoma / regional payer market and with multi-entity, multi-EHR (HB/PB/ASC) environments.
Responsibilities
- Provides a unified strategic and operational leadership for the end-to-end revenue cycle across Hospital Billing, Physician Billing, and Ambulatory Services Billing - building a single, continuum-based operating model.
- Establishes enterprise goals, budgets, and performance targets; owns overall revenue cycle results and reports performance to the CFO, Executive Team, and Board.
- Establishes and maintains clear ownership and accountability for every revenue cycle function, eliminating gaps and duplication of services across the NRHS locations and service lines.
- Drives net-revenue improvement and cash acceleration through management of A/R days, DNFB, discharged-not-final-coded (DNFC), and aged/high-dollar work-in-process (WIP) segmentation.
- Monitors and improves key revenue cycle KPIs using data-driven scorecards and dashboards to include cost-to-collect, clean-claim rate, denial rate, underpayment recovery, POS collections, bad debt and charity — using data-driven scorecards and dashboards.
- Partners with Finance on reserves, write-off governance, cost reporting, and month-end close as it relates to net revenue.
- Strengthens point-of-service collections and price-transparency / good-faith-estimate compliance.
- Ensures accurate, compliant, and timely coding, CDI, and utilization review; oversees charge integrity and CDM governance to protect expected reimbursement and reduce revenue leakage.
- Coordinates clinical denials prevention and government-audit response with clinical and denials leadership.
- Oversees billing/claims, cash posting, customer service, A/R and self-pay follow-up, and technical denials across all NRHS locations and service lines.
- Establishes productivity and quality standards, worklist discipline, and vendor performance expectations for back-end operations.
- Directs payer contracting and negotiation strategy, denial root-cause analysis and enterprise-wide denials prevention, payer escalation, and underpayment recovery.
- Provides oversight of payer relationship management, working closely with both internal and external partners.
- Manages revenue cycle vendors and platforms (e.g., EHR/billing systems, analytics, denial/underpayment, early-out and bad-debt partners); define scope, service levels, and measurable accountability, and evaluate build-vs-buy decisions.
- Recruits, develops, and retains a high-performing management team; establishes repeatable processes, SOPs, and governance for sustained performance.
- Fosters strong collaboration across clinical, financial, technological, and operational departments, including leading a regular cadence of revenue cycle governance and committee forums.
- Positions Revenue Cycle as a proactive organizational partner rather than a standalone function. Ensures consistent upstream communication and engagement so opportunities and concerns are identified and addressed before they become operational issues
- Ensures compliance with federal and state regulations, payer requirements, and organizational policy across all revenue cycle functions.
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What This Job Offers
Job Type
Full-time
Career Level
Director
