Executive Director Revenue Cycle

Nicklaus Children's Hospital•Miami, FL

About The Position

The Executive Director of Revenue Cycle leads the end-to-end revenue cycle across Nicklaus Children's Health System. Provides oversight of front-end, mid-cycle, and back-end revenue functions and is accountable for achieving performance targets. Partners closely with operational leaders, Managed Care, Finance, IT, and external vendors to drive sustainable financial performance, operational efficiency, and a high-quality patient experience aligned with the organization's mission to deliver exceptional pediatric care.

Requirements

Bachelor's Degree in Business or Healthcare Administration
7-10 years of progressive experience in the healthcare revenue cycle
Healthcare industry financial statistical indicators experience
Proven ability to lead large-scale operational and transformation initiatives.
Deep understanding of end-to-end revenue cycle processes, including, billing, coding, reimbursement, and denial management.
Strong leadership and communication skills.
Experience in negotiating contracts and resolving vendor/service issues.
Demonstrated experience managing outsourced revenue cycle vendors or shared services models.
Knowledge of healthcare regulatory requirements and payer dynamics.

Nice To Haves

Master's degree preferred.
HFMA, AAHAM, or similar professional certification preferred.
Epic experience preferred.
Florida Medicaid experience preferred.

Responsibilities

Lead and optimize all components of the revenue cycle, including: Patient access (scheduling, registration, authorization, financial counseling), Case Management, Social Work, Pastoral Services, and Transfer Center, Health information management (HIM), coding and CDI, Revenue integrity, Charge Description Master (CDM), charge capture, and billing, Patient financial services, A/R follow up, Appeals and Underpayments, Cash/Credit Management, and Customer Service.
Ensure seamless coordination across all functions to achieve timely and accurate revenue capture and reimbursement.
Lead governance and performance management of the organization's outsourced revenue cycle vendor(s), including: Establishing and enforcing SLAs tied to key KPIs (e.g., net collection rate, AR days, denial rate), Conducting regular business and performance scorecard reviews, Driving continuous improvement and corrective action plans for underperformance, Partnering on optimization initiatives (automation, AI, workflow redesign).
Oversee contract performance, escalation management, and alignment of vendor operations with system goals.
Oversee key revenue cycle metrics, including, but not limited to: Days in AR, Denial rates, Net collection rate, including complex large balance claims, Bad debt performance, Excess/Avoidable Days, Coding accuracy, Point of Service Collections, Call Center and Pre-Access Metrics: Speed to Answer, Accuracy, Authorization Days Out, etc., Patient Financial Experience.
Develop and maintain a structured performance reporting framework and accountability forums.
Analyze trends and implement targeted initiatives to improve financial outcomes.
Partner with leadership and vendor partners to define and execute a multi-year revenue cycle strategy: Technology optimization (e.g., EMR revenue cycle platforms, automation, analytics tools), Shared services and operating model design, Integration of vendor and internal workflows.
Collaborate with IT teams and vendors to identify system enhancements and ensure alignment with business needs.
Ensure adherence to all regulatory, payer, and compliance requirements (IRS, OIG, CMS, HIPAA, payer contracts).
Mitigate financial risk through strong internal controls and processes.
Lead and develop a high-performing revenue cycle organization, including internal leaders and vendor teams.
Establish clear accountability structures, performance expectations, and training programs.
Foster a culture of continuous improvement, collaboration, and service excellence.
Demonstrate strong communication and collaboration skills across the enterprise.
Partner with clinical and operational leaders to enhance transparency and the overall patient financial experience.
Ensure patient-friendly billing practices and effective patient financial assistance programs.