Senior Director Enterprise Patient Access and Financial Clearance

SUMMARY:

The Sr. Director, Enterprise Patient Access & Financial Clearance (Hospital and Professional) provides enterprise-wide strategic and operational leadership for all front-end revenue cycle functions across hospital and professional billing environments. This role oversees patient access operations including scheduling, admissions, discharge, transfer (ADT), registration, insurance verification, authorization, and financial clearance to ensure optimal patient experience, regulatory compliance, and revenue integrity.
Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

Instill Trust and Value Differences
Patient and Community Focus and Collaborate
RESPONSIBILITIES:

KEY RESPONSIBILITIES:

Provide enterprise leadership for Patient Access, ADT, Registration, Financial Clearance, and the centralized PAC functions across all RI and MA entities.

Standardize all policies, workflows, KPIs, and training across Rhode Island and Massachusetts regions under one centralized leadership team to ensure accountability and alignment.

Lead and manage Directors of Hospital Patient Access (RI & MA) and the Director of Ambulatory Patient Access (PAC), ensuring site-based directors manage day-to-day operations whilemaintainingenterprise standards.

Drive the strategic separation of patient-facing, real-time activities (hospital-based teams) from payer-facing, standardized functions (centralized PAC), reducing duplication andeliminatingconflicting workflows across facilities.

Epic System Optimization (Prelude, Cadence, ADT, Resolute HB/PB)

• Lead access operations across Epic Prelude, Cadence, ADT, and integrated Resolute HB/PB environments.
• Leverage Epic tools to drive standardization,workqueueaccountability, automation, and denial prevention-ensuring the organizationmaximizesits Epic investment.
• Partner with IT tooptimizeEpic workflows, build rules, automation, and real-time reporting dashboards.
• Oversee Epicworkqueueownership mapping and accountability grids across PAC vs. hospital-based registration/financial clearance models.

Centralized Patient Access Center (PAC) Oversight

• Oversee the corporate PAC shared services model, including:
• Pre-registration & Insurance Verification -Validating demographics and insurance data prior to date of service across all entities
• Authorization Management -Submission, follow-up, and documentation tracking for inpatient, outpatient, high-tech radiology, and surgical day care services
• Eligibility & Benefits Verification -Interpreting payer responses,identifyingrequirements for prior authorizations, referrals, and medical necessity validation
• Financial Clearance -Centralized pre-service financial clearance, estimates, and POS collections
• Denials Prevention -Proactive strategies to reduce access-related claim denials and improve clean claim performance

On-Site / Hospital-Based Access Operations

• Ensure hospital-based teamsretainownership of activities requiring physical presence, immediate clinical coordination, and direct patient interaction, including:

• ED Registration & Triage Registration

• Bedside / Inpatient Admitting & ADT

• Outpatient Front Desk Check-In

• Point-of-Service Financial Counseling & Collections

• Consent & Document Collection

• Medicaid & Charity Program Support

Revenue Integrity & Denial Prevention

• Develop and execute strategies to reduce access-related denials and improve clean claim performance across HB and PB.
• Ensureaccuratedemographic and insurance capture across hospital and professional settings.
• Lead root cause analysis for top denial categories including No Authorization, MedicalNecessity, andEligibility Errors, and implement corrective action plans.
• Establish KPIs aligned with HFMA and CHAM benchmarks for registration accuracy, pre-registration rates, authorization rates, and POS collections.

Compliance & Regulatory

• Ensure compliance with federal, state (RI & MA), and payer regulations including CMS, HIPAA, No Surprises Act, and MassHealth requirements.
• Maintain current knowledge of payer-specific billing requirements and credentialing/enrollment dependencies that impact patient access.
• Support compliance with state-specific requirements for multi-state operations (e.g., MA licensing, payer enrollment across state lines).
• Patient Experience
• Championa patient-centered access experience across all touchpoints-from pre-service through discharge-recognizing that revenue cycle has among the most patient interactions before and after care.
• Implement digital access innovations including MyChart integration,eCheck-In adoption, and automated patient communication.

Leadership & Team Development

• Lead and develop a multi-level leadership team including Directors, Managers, Supervisors, and Team Leads across RI and MA.
• Drive staff recruitment, retention, performance management, and succession planning.
• Foster a culture of accountability, continuous improvement, and professional development.
• Collaborate cross-functionallywith Finance, HIM, Coding, Compliance, Clinical Operations, Payer Contracting, and IT.

PERFORMANCE STANDARDS:

• Strategic thinking with hands-on operational execution

• Data-driven decision-making using Epic dashboards and analytics

• Change management and large-scale process improvement

• Cross-functional collaboration and stakeholder management

• Strong communicationskills for executive, board, and front-line audiences

• Multi-site, multi-state healthcare operations management

Qualifications / Education

• Bachelor's degree in business, Health Information Management, Finance, Healthcare Administration, or related field;

Minimum 8-10 years of progressive leadership in patient access, revenue cycle, or healthcare operations, with at least 5 years in a senior management role in a large, multi-entity health system.

• Epic Proficiency:Extensive hands-on experience with Epic Prelude, Cadence, ADT, Grand Central, Resolute HB/PB, and associated revenue cycle modules in an enterprise environment.

• Deep understanding of hospital and professional billing workflows, payer requirements, authorization processes, and financial clearance operations.

• Demonstrated success in denial prevention, clean claim optimization, and access-related KPI improvement.

• Knowledge of CMS, HIPAA, No Surprises Act, state regulations (RI/MA), and payer-specific policies.

Preferred

• Education:Master's degree (MBA, MHA, or equivalent).

• Certification:CHAM (Certified Healthcare Access Manager), CHFP, or equivalent professional certification.

• Experience leading centralized Patient Access Center / shared services models in a multi-state, multi-entity academic health system.

• Experience with Epic implementations, go-lives, and system transitions (e.g., legacy system migrations to Epic).

• Familiarity with HFMA, MGMA, and NAHAM benchmarking standards.

• Experience managing access operations during acquisitions, CHOW events, and new entity integrations.

WORKING CONDITIONS:

Office-based role with potential hybrid or fully remote work arrangements.

Requires occasional travel to other facilities, corporate offices, or industry conferences as needed.

Pay Range:

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

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