Executive Director Revenue Cycle

Job Summary

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.

About the Role

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

Responsibilities

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), inluding:
• 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

Qualifications

• Minimum Job Requirements: Bachelor's Degree in Business or Healthcare Administration 7-10 years of progressive experience in the healthcare revenue cycleHealthcare industry financial statistical indicators experience
• Knowledge, Skills, And Abilities: Master's degree preferred.HFMA, AAHAM, or similar professional certification preferred.Epic experience preferred.Florida Medicaid experience preferred.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.