Sr Director Denials Prevention - Remote Opportunity

JOB SUMMARY – Sr.
Director Denials Prevention The Senior Director, Denials Prevention is at the heart of cross-functional collaboration and partnership maximizing efficiencies across Revenue Cycle and Clinical teams to secure revenue.
This role will help to champion continuous improvement practices and foster an environment in which continuous improvement becomes a daily pursuit.
This person is a key leader and contributor in defining strategies that will impact multiple service line work streams and will lead the Continuous Improvement team in efforts to develop, analyze, measure, optimize, and document key revenue cycle processes across the organization that drive value by being effective, efficient, flexible, and scalable.
At its core, the Senior Director, Denials Prevention role is defined by a holistic understanding of cross functional business processes within Hospitals, O/P Centers and the Revenue Cycle.
Strategic communication, problem solving, and risk management skillsets are essential to be successful in this role.
The Senior Director of Denials Prevention needs to have the experience and competencies to proactively lead collaborative efforts across functional teams at multiple levels.
They are accountable for providing a stable foundation for rigor that will enable the execution of company objectives.
The candidate will need the executive and emotional presence to inspire and influence change across the organization.
ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following.
Others may be assigned.
No.
Description 1.
Lead the Denial Prevention Strategics working cross-functionally to identify, analyze and document current and future business needs and collaborating with service delivery teams on the design and implementation of the desired solution 2.
Ensure the quality of continuous improvement initiatives by establishing and monitoring the company’s KPI’s in partnership with Local and National Operations.
3.
Responsible for effective use of change management tools and techniques to assure adoption and buy-in of all stakeholders to the processes and systems across the company.
4.
Monitor the results of improvement projects and publish reports.
5.
Champion continuous improvement methodologies (e.
g.
, Lean) and the value of seeking improvement every day.
6.
Develop and maintain policies and procedures to manage the Root Cause Analysis.
Manage within compliance with policies & procedures.
7.
Participate in the relevant Revenue Cycle Meetings, Denials Prevention, Technology and strategy steering committees as needed.
8.
Use the concept of daily improvement to continually expand knowledge of company's business.
9.
Supervise, coach and mentor our Billing Integrity team to drive improvements within the Patient Accounting Systems, Billing Editors and data output to improve our First Pass Payment Rate 10.
Acts as a mediator between Revenue Cycle, Non Revenue Cycle, Technical and Business teams to ensure understanding of expectations through data and process improvement FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense) Support oversight of budget (department revenue and expense) for operational initiatives.
SUPERVISORY RESPONSIBILITIES This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws.
Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
No.
Direct Reports (incl.
titles) TBD No.
Indirect Reports (incl.
titles) TBD KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed below are representative of the knowledge, skill and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Extensive healthcare revenue cycle and operational knowledge, preferably in a service provider setting and/or consulting.
Ability to work and coordinate virtual workforces across multiple geographic locations.
Proven ability to execute on operational initiatives to drive results.
Strategic thinking, problem solving and conflict resolution skills.
Strong collaboration and persuasion skills to coordinate work efforts across multiple departments.
Strong presentation and communication skills, with the ability to communicate to a wide range of audiences from senior executives to front-line employees to client leaders.
Leadership skills to motivate employees to excellence.
Ability to analyze data among multiple reports to determine areas for opportunity.
Advanced knowledge of process metrics (cycle times, attrition rates, etc.
) and how they can be used in the healthcare revenue cycle environment.
Extensive knowledge of revenue cycle metrics and drivers, particularly in billing and collections (AR days, cash goals, aging, compliance metrics) Strong management and leadership skills in a matrixed environment.
Ability to be detailed-oriented while still maintaining a big picture perspective.
Must have a solid understanding of revenue cycle functions, specifically how technology supports business processes.
Ideal candidate must have excellent presentation and meeting facilitation skills.
Ability to influence others cross-functionally, including senior executive leadership.
Ability to effectively translate business needs to technical teams and vis versa to ensure expectations for both are clearly understood.
EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job.
8+ years of healthcare revenue cycle management experience, with significant experience leading high impact continuous improvement projects Bachelor’s degree in business, healthcare or related field Track record of delivering significant performance improvements.
Project Management experience/ certification is a plus.
Lean Six Sigma and Change management experience is required.
OTHER Approximately 50% travel may be required.