Regional Revenue Manager / PA Administration

Hartford HealthCare-posted 2 months ago
Full-time • Mid Level
Farmington, CT
1,001-5,000 employees
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This position supports the Regional VP’s of Finance with accountability to develop strategies to monitor, evaluate and maximize revenues across the assigned region. Establishes continuous improvement processes to maximize technical resources, enhance service delivery and standardize systems and services acting as the primary point of contact between service/program level management and system support functions including Finance, Utilization Management, Revenue Cycle and Compliance. Works in support of the strategic initiative to standardize program design and delivery across the region by working with operational leaders of each service line to identify opportunities to minimize revenue 'leakage', maximize charge capture, and reduce waste, as well as to develop business plans for identified service expansion. Responsible for analyzing revenue streams for the purposes of understanding performance against budget, as well as optimization and identification of enhancement opportunities and maintaining revenue integrity. Evaluates and recommends improvements in contracting in order to ensure all revenue opportunities available are realized to support service delivery. Incorporates findings from the analysis of revenue streams and clinical programming to collaborate with Finance leadership in defining opportunities for revenue optimization through managed care contracting to ensure that we capture all available revenue opportunities and are appropriately compensated for our services. Serves as a key point of contact between Regional programs and the various functional areas under Revenue Cycle including financial clearance, benefit verification, utilization management, billing/follow-up, denial management and compliance. This includes functioning in multi-disciplinary teams as needed to build out systems to implement revenue cycle initiatives. Liaisons with HHC Revenue Cycle Division to develop strategies for denial prevention, reviews denial trends with operational leaders, reviews revenue cycle KPI’s in order to communicate back to leaders. Supports HHC Revenue Cycle policies within the Regional network. In coordination with Regional VP of Finance, sets financial goals for the system. Directly oversees business solutions team which services to monitor the revenue stream and support operational performance.

  • Develops strategies to enhance and grow revenues of the region through revenue enhancement initiatives as well as by leading development of new revenue streams in collaboration with strategic partners and clinical operators.
  • Directs implementation of revenue improvement initiatives by managing business partners in collaboration with system support resources dedicated to specific projects as approved by the Cabinet under the direction of the VP Finance.
  • Directs the Business Solution team in the execution of revenue analysis, process improvement and business development.
  • Provides revenue expertise in the development of strategic planning initiatives.
  • Maintains active membership on Steering Committees, bringing expert knowledge of services, revenue cycle processes, and clinical practice management to the group.
  • Directs onboarding, steering and implementation of SBAR initiatives as they relate to revenue optimization.
  • Maintains knowledge and skill required to assure accurate and timely reimbursement. Manage staff, projects, and systems that impact the success of achieving successful fiscal integrity related to network services.
  • Develops and implements department budget that demonstrate efficiency and prudent utilization of resources.
  • Establishes goals for operational performance including accurate registration, primary denial rate, and turnaround time for charge posting and record completion that aligns with HHC organizational Goals.
  • Collaborates with the Management team to implement and monitor success.
  • Conducts patient registration reviews for accuracy and timeliness.
  • Collaborates with the Management Team to optimize pre-registration, insurance verification, and financial counseling at scheduling, registration, and at discharge.
  • Supports HIM to ensure Medical Records are maintained accurately, utilizing electronic and paper formats.
  • Assures critical data elements are analyzed to identify and correct deficiencies.
  • Assures compliant release of patient’s records following prescribed policies and procedures to protect the privacy of the patient, and meet Federal and State regulation.
  • Works with HHC Revenue Cycle billing, follow-up, and collections services to review for operational opportunities for improvement.
  • Monitors post billing audit activity and assists with resolving customer service billing inquiries.
  • Assures all assigned staff are trained and meet established performance standards.
  • Supports leaders in empowering staff to continuously develop performance improvement processes.
  • Input in daily operations and projects to improve all Revenue Cycle functions.
  • Assists staff in developing new skills and applying them to the work place.
  • Works with utilization management staff in all patient care sites in order to ensure timely and accurate care authorization, response to, and resolution of care denials.
  • Bachelor’s degree in HealthCare Management, Business Administration, or related field. Extensive experience may substitute for education.
  • Minimum: Two (2) to Three (3) years’ progressive experience in Healthcare Management in a Revenue Cycle or Financial leadership role.
  • Preferred: Five (5) years’ progressive experience in Healthcare Management in a Revenue Cycle or Financial leadership role.
  • Working knowledge in the areas of patient registration, health insurance practices and benefit design, billing, accounts receivable, managed care contractual terms and requirements, industry regulatory requirements, A.R. and financial reporting practices.
  • Ability to read and understand oral and written instructions, and effectively communicate information.
  • Basic computer skills (including opening/reading email, basic internet use).
  • Expert at managing Revenue Cycle workflow to assure optimum results.
  • Ability to manage large and diverse work groups to assure cohesive interactions to maximize achievement at meeting department and Organizational Goals.
  • Competitive benefits program designed to ensure work/life balance.
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