The Senior Director of Revenue Management reports to the CFO and is responsible for overseeing the development and implementation of current and future strategies to improve revenue results by taking a global view of clinical and financial processes, functions and interdependencies. This position will work closely with the Billing, Finance and Accounting Departments on revenue cycle performance to meet the strategic goals of Ryan Health. Candidates must be experts in planning, implementing and managing Revenue Cycle Management (RCM) process and strategies.
The Senior Director will be responsible for insurance eligibility processes, charge processing, claims submission, and processing, payment posting, collections and accounts receivable, denial management, reporting results and analysis, concurrent and retrospective auditing, proper coding, credentialing, insurance contract review and oversight, customer services relative to revenue cycle, training and development related to revenue cycle, analytics of key performance indicators, and all other revenue cycle management activities. This work is carried out in support of the mission and goals of Ryan Health.
· Develop strategic plans/programs for RCM team and ensure goals/objectives are properly defined and clearly established.
· Develop and ensure implementation of policies, guidelines, and implementation procedures.
· Monitor effectiveness of activities, ensuring that outstanding authorizations, billings, postings, collections and accounts receivables are within established time limits and that bad debt is within budget.
· Enhance and standardize workflows. Develop and implement billing practices by leveraging technology to automate, and standardize processes.
· Conduct regular meetings with the team to ensure implementation of all RCM plans, programs, and projects is adhering to deadlines.
· Conduct performance coaching and discipline management for staff.
· Identify, analyze and address challenges and/or breakdowns in the revenue cycle process.
· Responsible for maximizing the collection of payments and reimbursement from patients, insurance carriers, government agencies, and guarantors.
· Design/develop training programs for development of technical competencies of the team.
· Develop performance measures and standards that are used for team’s annual performance review.
· Ensure that overall performance of the team is on track.
· Consolidate status reports for monitoring weekly progress of various activities within the team.
· Manage the authorization/billing/collection staff in handling patient/payer relations and handles complex complaints and issues.
· Ensure adherence to HIPAA and security regulations.
· Develop department budgets and ensure that operating expenses are within budget and guidelines by providing regular analysis and forecasts.
· Design and develop the organization structure for RCM team.
· Delineate, define, and streamline functional activities, ensuring maximum utilization of all resources.
· Responsible for measuring, monitoring and meeting key performance indicators and departmental goals in accordance with the company’s established policies and procedures and industry best practices.
· Regularly provide CEO, CFO, and revenue cycle staff with revenue cycle status including reports, key performance indicator metrics, and presentations.
· Stay abreast of Medicare/Medicaid and third-party payer billing guidelines and communicate these changes to all interested parties.
· Attend all meetings and/or training sessions as required.
· Immediately report any problems and unusual occurrences to supervisor.
· Other special projects/assignments as needed.
Minimum Experience and Skills Required:
Education, Licenses and/or Certifications Required:
Equal Opportunity Employer
Ryan Network is an Equal Opportunity / Affirmative Action Employer and does not discriminate because of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, gender identity, military veteran status, or any other characteristic protected by law. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.