Vice President, Revenue Cycle Management

Family & Children's Services•Tulsa, OK

About The Position

The Vice President provides strategic leadership for revenue cycle management, including implementation of new RCM software, performance analysis, operational transition, payer relations, and contract implementation in a CCBHC environment. The role drives and optimizes the revenue continuum using industry best practices, lean office methodology, automation, technology, and data analytics. The VP stays current on developments in revenue cycle management, technology, access management, and payer contracting, including managed care, while ensuring operations meet applicable federal and state requirements and insurer agreements. The position collaborates closely with other departments and clinical leadership to improve efficiency, accuracy, and compliance. The VP oversees end-to-end revenue cycle operations and the revenue cycle management team, including enrollment, billing, payment processing, denials management, and collections. The role leads billing, promotes coding accuracy and timeliness, chairs the Revenue Cycle Committee, establishes and reports on KPIs, and uses business intelligence to identify trends and process improvements. It also oversees Medicaid managed care contracts, payer relationships, contract performance, reimbursement issues, regulatory compliance, risk identification, staff training, and related policies. The position requires a valid driver license, satisfactory driving record, use of a personal automobile to travel to locations other than the primary office, and proof of automobile insurance. It is classified as safety-sensitive and is subject to drug and alcohol testing, including random testing.

Requirements

Bachelor's degree in Healthcare Administration, Business, Finance, or a related field is required; extensive experience with progressive responsibilities without a bachelor's degree may be considered if the candidate agrees to obtain one.
At least 10 years of progressively responsible leadership experience in revenue cycle and related operations, including end-to-end revenue cycle management, billing, receivables, credentialing, claims processing, and payer relations within a complex healthcare environment.
At least five years of experience in senior leadership.
Extensive healthcare industry knowledge, including billing processes, revenue optimization, medical coding, reimbursement methodologies, and regulatory compliance.
Proven track record of strategic leadership and successful project management.
Comprehensive knowledge of the entire revenue cycle, medical coding, reimbursement methodologies, industry best practices, and healthcare regulations and compliance standards, including ICD-10, CPT, HCPCS, HIPAA, Medicare, and Medicaid.
Proficiency in revenue cycle management software, EHR systems, billing software, and data analytics, with the ability to use technology to improve processes and ensure compliance.
Strong analytical, organizational, and project management skills, including the ability to interpret complex data, oversee operations, and make evidence-based decisions.
Proficiency in financial concepts, problem-solving, and multitasking, with the ability to resolve billing, denials, reimbursement, and revenue optimization issues.
Exceptional leadership and strategic thinking skills, including the ability to develop high-performing teams and execute a revenue cycle strategy aligned with organizational goals.
Excellent communication and collaboration skills, including expertise in change management and decision-making.
Valid driver license and satisfactory driving record.
Ability to use a personal automobile for travel to locations other than the primary office and provide proof of automobile insurance.

Nice To Haves

Master's degree preferred.
Certified Professional Biller (CPB), Certified Revenue Cycle Professional (CRCP), or Healthcare Financial Management Association certification is a plus.

Responsibilities

Create synergies and streamline workflows across the revenue cycle, implementing efficient and compliant processes.
Alert F&CS leaders to impactful developments, maintain Key Performance Indicators, and contribute to strategic planning, budgeting, and work plans.
Oversee the revenue cycle management team and optimize end-to-end operations, including enrollment, billing, payment processing, denials management, and collections.
Implement best practices to minimize billing errors and collaborate with senior clinical leadership on performance improvement.
Lead the billing process, ensuring coding accuracy, compliance, and timeliness.
Drive automation and uniformity through technology, continuously improve revenue cycle performance, and adhere to policies and procedures.
Chair the Revenue Cycle Committee and use business intelligence to analyze trends, reduce claim denials, and identify process improvements.
Establish and report revenue cycle KPIs, define performance expectations, and provide routine feedback.
Consistently report revenue cycle performance to ensure transparency and accountability.
Manage Medicaid MCO contracts, ensure compliance with guidelines and regulations, analyze performance metrics, and ensure billing practices align with contract terms.
Collaborate with internal departments and external partners to optimize contractual arrangements and resolve issues.
Serve as the primary payer liaison, maintain relationships, and facilitate communications.
Monitor contract performance, resolve reimbursement issues, and recommend new payer relationships or products.
Ensure adherence to healthcare regulations, coding guidelines, and billing compliance standards.
Collaborate with compliance and legal departments to develop policies and educate team members.
Support staff training and maintain strategies to identify and analyze organizational risks, alerting F&CS leadership as needed.
Use a personal automobile to travel to locations other than the primary office and provide proof of automobile insurance.