Beth Israel Deaconess Medical Center APG Revenue Cycle Director in Needham, Massachusetts
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APG Revenue Cycle Director
Department Description:Beth Israel Deaconess HealthCare is a network of more than 100 highly-skilled primary care physicians and specialists who are affiliated with the renowned Beth Israel Deaconess Medical Center in Boston, Beth Israel Deaconess Hospital-Needham, Beth Israel Deaconess Hospital-Milton and Beth Israel Deaconess Hospital-Plymouth. Our Central Office is located in Needham, MA. This is a hybrid position remote and onsite.
Job Location:Needham, Massachusetts
Job Summary:The Director of Revenue Cycle is responsible for managing and partnering with key stakeholders that contribute to and support the Beth Israel Lahey Health Primary Care (BILHPC) revenue programs including strategic initiatives and activities. Actively seeks opportunities to maximize revenue generation, ensures compliance with relevant regulations and supports financial and operational success at BILHPC. The Director of Revenue Cycle reports to BILHPC's Chief Financial Officer, partners with Operations Leadership and is a member of the BILHPC Leadership Team.
Participates as a key member on multiple committees and leadership teams. Including but not limited to BILHPC Operations Committees, BIDHC Executive Council, and BILH integration committees. Is expected to partner and collaborate with operations and clinical leadership and align organizational priorities while ensuring revenue optimization.
Revenue leader for all revenue activities including but not limited to revenue planning and identification and capture of all appropriate revenue opportunities in support strategic priorities including optimizing the patient experience, achieving provider work life balance and delivery of high quality care.
Maintains effective communication with leadership to ensure that all revenue is captured and results are fully compliant. Lead responsibility to support strategic initiatives to enhance the patient and provider experience while assuring optimization of revenue.
Collaborates with other Revenue Cycle leaders, as appropriate, for Lahey Health Services Systems (LHSS) and Mt. Auburn Physician Service (MAPS) to develop a standard set of KPIs for reporting to BILHPC leadership, identify opportunities to streamline practice operations to support Revenue Cycle performance and create standards and overarching policies to promote consistent processes.
Responsible for our Clinical Documentation Initiative (CDI) designed to optimize the quality of work life for clinicians through high quality clinical documentation, full and accurate charge capture and complete coding accuracy. Leading the effort to ensure staff obtain correct insurance and demographic information in order to expedite cash flow.
Lead the BIDHC Patient Financial Services team in the effort to capture revenue for all practices and departments. Ensures compliance with all payer and federal regulations. Responsible for all audit functions of revenue cycle. Coordinates, reviews, responds and reports to all audit findings from payers, RAC, OIG, internal audit, and others.
Lead the effort for BIDHC to achieve the highest potential from all systems utilized. Continues to develop new technology and processes to be most effective and efficient in revenue capture.
Monitors and reports on BIDHC key metrics such as cash collections, day's outstanding, unbilled services, denials, etc. Recommends and implements changes where appropriate after careful and measurable analysis in collaboration with BILH shared services where appropriate.
Lead support of risk contract performance through optimal risk adjusting clinical documentation and coding practices. .
Responsible for Patient Access and Patient Financial Services functions including financial clearance and counseling. Oversees revenue cycle processes to ensure optimal performance. Develops and continues to enhance reporting. Reports all trends, analysis and recoveries to Chief Financial Officer.
Has the responsibility to lead and support managers and directors in developing and improving operations to create optimal performance levels. Direct Reports: 4-6 Indirect Reports: 21-50
Has full responsibility for planning, monitoring and managing budgets for multiple departments.
Bachelor's degree in Management, Healthcare or Related Field required. Master's degree preferred.
8-10 years related work experience required and 8-10 years supervisory/management experience required
Revenue Cycle Management experience, including prior experience in institutional billing and extensive knowledge of Third Party payer billing practices.
Management experience specifically within the healthcare/operational/production environment.
Prior experience with reviewing and analyzing large amounts of data to identify trends and opportunities for improvement.
Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.
Decision Making:Ability to make decisions with significant, broad implications for the management and operations of a major department or multiple departments. Participates in decisions on overall strategy and direction of the organization.
Problem Solving:Ability to address problems that are broad, complex and abstract, often involving Medical Center-wide issues and requiring substantial creativity, resourcefulness, staff engagement, Lean diagnostic techniques, negotiation and diplomacy to develop solutions.
Independence of Action:Ability to set direction and vision for major departments or multiple departments. Establishes priorities, develops policies and allocates resources.
Written Communications:Ability to communicate complex information in English effectively in writing to all levels of staff, management and external customers across functional areas.
Oral Communications:Ability to verbally communicate complex concepts in English and address sensitive situations, resolve conflicts, negotiate, motivate and persuade others.
Knowledge:Ability to demonstrate broad and comprehensive knowledge of theories, concepts, practices and policies with the ability to use them in complex and/or unprecedented situations across multiple functional areas.
Team Work:Ability to lead and direct multiple collaborative teams for large projects or groups both internal and external to the Medical Center and across functional areas. Results have significant implications for the management and operations of the organization.
Customer Service:Ability to lead operational initiatives to meet or exceed customer service standards and expectations in assigned unit(s) and/or across multiple areas in a timely and respectful manner.
Physical Nature of the Job:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally
BIDMC is EOE M/F/VET/DISABILITY/GENDER IDENTITY/SEXUAL ORIENTATION
As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. BILH requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment.Learn more (https://www.bilh.org/in-the-news/2021/8/10/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement