Sr. Director, Revenue Cycle Management

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Reporting to the VP, RCM, the Senior Director of Revenue Cycle Management (RCM) is responsible for the success of revenue cycle operations across all markets. The Sr. Director reviews and enacts policies, procedures and processes related to revenue cycle functions and holds teams accountable to established key performance metrics.This individual works closely with the senior leaders in the market as well as other operating divisions within Privia including; Finance, Analytics, Implementation, Credentialing, Performance Management, Population Health and New Product Development. The successful candidate will provide leadership to staff; communicate and model mission, vision, values and promises of Privia Health. He/she will adhere to the Privia Health Compliance Plan and privacy standards of the organization.The Sr. Director is responsible for analyzing performance against established benchmarks and providing advice and support to senior management regarding matters related to all aspects of revenue management Qualifications
Oversees and manages end to end Revenue Cycle Management for assigned markets and other national RCM projects.
Serves as the senior subject matter expert on all issues surrounding payer reimbursement, accurate claim processing, claim submission, collections and other general revenue cycle management.
Responsible for root cause analysis and resolution of market issues, and escalating issues to RCM and Market Operations leadership, as necessary.
Serves as the liaison to market or national committees such as Compliance, Payer & Audit and other committees as assigned.
Conducts both weekly standup and monthly staff meetings.
Provides management, guidance and training to staff and will perform duties of staff when necessary to maintain practice operations.
Reviews daily, monthly and weekly A/R dashboards. Identifies opportunities for improvement and develops plans to implement necessary changes to meet performance expectations.
Participates in annual budget development, and is accountable for departmental adherence to budget and/or other fiscal goals.
Manages teams responsible for the accuracy and financial viability of the accounts receivable. Assigns/allocates resources as required ensuring company goals for aging and accounts receivable days are met.
Reviews accounts receivable on at least a monthly basis with each Market President and Regional Vice President to ensure A/R is within established standards.
Works with RVPs, Market Presidents and subordinate staff to create action plans to address variances in A/R to standards.
Responsible for departmental policies and procedures, providing recommendations when appropriate and ensuring compliance.
Responsible for staffing to include hiring, termination, coaching and training.
Provides ongoing feedback to staff of performance throughout the year to subordinate staff.
Counsels employees in disciplinary matters and obtains assistance from human resources appropriately for disciplinary actions and/or employee termination process.
Recruits, interviews and hires personnel as necessary.
Minimum Qualifications: Bachelor of Science/Business Administration degree preferred
Experience in managing physician revenue cycle. Thorough understanding of all payers including all major commercial payers as well as Medicaid and Managed Medicaid across multiple markets.
AthenaOne EMR experience required Strong and effective results-oriented team leader with a minimum of seven years of experience managing large, multi-specialty physician groups (50+) of varying levels of complexity
Excellent analytical skills, facile with Microsoft Excel.
Must be able to critically evaluate data and make recommendations for change based on solid research and evidence.
Solid knowledge of industry trends, regulations, payment models and demonstrated skill in managing in a complex reimbursement model across multiple provider specialties.
Must possess a thorough understanding of medical information systems for billing and accounts receivable, spreadsheet analysis, reporting applications, medical terminology, and coding and office procedures
Successful history of adding value to organizations through proactive root cause analysis and resolution of bottlenecks that negatively affect reimbursement and accounts receivable
Demonstrates a record of significantly improving patient accounts receivable
Must comply with HIPAA rules and regulations
The salary range for this role is $128,000 - $132,000 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 15% based on performance in the role and restricted stock units.
Location:
Remote

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