Senior Vice President of Revenue Cycle

Responsibilities

• Develop and implement enterprise-wide revenue cycle strategy including life-cycle planning for billing systems and related technologies.
• Lead, coach, and develop a high-impact team of top talent, fostering a culture of accountability, continuous improvement, and emphasis on the client journey.
• Ensure adherence to federal, state, and payer-specific regulations including CMS and value-based care initiatives.
• Leverage technology including automation and AI as well as data analytics to improve revenue cycle performance, reduce denials and overall cost to collect.
• Partner with field branch operations and contracting leadership to ensure smooth revenue cycle integrations with patient care workflows.
• Manage all aspects of the revenue cycle including but not limited to billing, collections, cash posting, contract analysis, communications with insurance providers, and account management.
• Define, track, and analyze revenue cycle KPIs, drive continuous improvement, and present strategic insights and actionable recommendations to CFO and finance business partners.
• Develop sustainable processes to bill and adjudicate claims timely to maintain a benchmark cash goal.
• Define denial management processes to eliminate denial root causes and reduce the denial impact on the organization.
• Collaborate with clinical departments to resolve and expedite solutions.
• Partner with contracting and operations teams to evaluate collection capabilities and adherence to payer contracts.
• Build strong relationships with internal business partners by proactively addressing challenges and balancing solutions with their operational and clinical needs.
• Account for internal control responsibilities in line with the organization’s objectives.
• Investigate and resolve complex RCM problems and coordinate efforts to provide innovative strategies and solutions.
• Serve as subject matter expert for revenue cycle performance, stay abreast of payer requirements and changes in the industry and communicate those changes to team and leadership.
• Assess and respond to current and future internal and external healthcare trends to establish and ensure the necessary direction for revenue cycle activities.
• Develop and control annual departmental budget for Revenue cycle function.
• Recommend and establish overall financial policies and programs to administer the financial or business aspect of patient services ensuring appropriate internal controls are in place and adhered to.
• Perform other duties as assigned.

  Qualifications

  • Require a bachelor's degree of accounting, finance, healthcare administration, or related field of study. MBA or MHA preferred.
  • 12+ years of progressive management experience.
  • At least 10 years of experience managing Professional Billing / Revenue Cycle Management and/or Collections in a large healthcare provider setting or a Medical Claims Processing organization.
  • Proven experience in successfully leading revenue cycle teams (larger than 30 employees) and implementing strategic initiatives to optimize financial performance and maximize cash collection.
  • Extensive knowledge of government and payer billing regulations and payer requirements.
  • Understanding of third-party payer contracting language and reimbursement terms.
  • Experience with multiple billing and eMR systems.
  • Solid grasp of medical terminology, ICD9/10, CPT, and HCPC coding.
  • Strong organizational, time management, and analytical skills.
  • Possesses the versatility required to be a leader, manager, teacher, coach, and mentor while placing high value on people and process.
  • Experience in designing and executing workflows to operationalize best practice strategies for payments/collections.
  • Strong proficiency in Microsoft Office Suite (Power Point, Word, and Excel) at the intermediate to advanced level.
  • Excellent communication and interpersonal skills to collaborate with internal stakeholders, including CFO, finance teams, and senior executives, as well as external partners such as payers and vendors.
  • Ability to drive change, manage multiple complex projects, and deliver measurable results.
  • Must be able to assess situations, identify issues/problems and prioritize duties.
  • High ability to thrive in a fast-paced, highly dynamic environment and leverage available data to be decisive in unstructured environments.

  About Our Line of Business

  BrightSpring Health Services provides complementary home- and community-based health solutions for complex populations in need of specialized and/or chronic care. Through the Company’s service lines, including pharmacy, home health care, and rehabilitation, we provide comprehensive and more integrated care and clinical solutions in all 50 states to over 475,000 customers, clients and patients daily. BrightSpring has consistently demonstrated strong and industry-leading quality metrics across its services lines, while improving the health and quality of life for high-need individuals and reducing overall healthcare system costs. For more information, please visit www.brightspringhealth.com. Follow us on Facebook, LinkedIn, and X.