VP, Revenue Cycle Management Operations

Job Description:

• Oversee a large team of RCM operators and global partners/vendors to ensure their accountability for contracted deliverables across Credentialing, Coding, Claims Management, Payer & Patient Accounts Receivable Management, Payment Management and Patient Access
• Develop and maintain effective relationships with internal and vendor leaders to ensure contracted deliverables, Service Level Agreements (SLAs) and business metrics are met
• Establish and monitor KPI to ensure high quality service delivery and continuous improvement
• Direct, coordinate, and evaluate the performance of operational areas, and proactively initiate process & system improvements for the ongoing enhancement of service performance
• Review reports and records of activities to ensure progress is being accomplished toward specified program objectives; modify or change methodology as needed to redirect activities and attain objectives
• Partner with RCM compliance team to ensure applicable laws, regulator considerations, policies, and procedures which govern proper medical conduct, medical billing, and healthcare are followed by team members and contracted entities. Handle escalations as needed or when/if violations in compliance are identified
• Ensure onboarding and ongoing training programs meet the needs of the employees and partner organizations, and drives effective and efficient results in the division
• Partner with company-wide Staff Development team to define where handoff of services takes place to ensure seamless integration
• Monitor financial performance, manage ongoing operational expenses, and plan for staffing to meet client demand
• Build/scale teams and vendor/partner relationships as needed to scale with sales pipeline and delivery
• Create customer satisfaction by optimizing the current organization, integrating teams, developing unified processes and procedures, and directing daily operations with a client-performance-centric focus and full leverage of technology solutions
• Perform other duties that support the overall objective of the position

Education Required:

Bachelor's degree in Business or related discipline.

Or, any combination of education and experience which would provide the required qualifications for the position.

Experience Required:

12+ years of experience in Revenue Cycle Management, Healthcare, or similar experience.

8+ years of experience working with multiple levels of leaderships within a healthcare environment

Demonstrated experience working with RCM BPO organizations at scale

Or, any combination of education and experience which would provide the required equivalent qualifications for the position.

Knowledge, Skills & Abilities:

Knowledge of: Knowledge of Revenue Cycle Management best practices. Knowledge and understanding of business processes and drivers for large providers. Knowledge and understanding of contract negotiations.

Skill in: Leadership, executive level communication and presentation skills, negotiation, strategic and analytical.

Ability to: Leverage best practices to identify and ensure customer needs and opportunities to improve internal practices and efficiencies; manage and establish credibility within an organization; demonstrate supportive cross-functional relationships with peers, clients, partners, and management; oversee and balance multiple competing priorities; manage multiple high-level projects and teams through delegation and empowerment of new and upcoming leaders; cultivate relationships and develop/coach team members to further their leadership and managerial skills; execute large, cross-functional processes and initiatives; establish a productive team-based work environment and collaborate effectively across multiple functional areas; influence others to perform their jobs effectively and to be responsible for making decisions.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.

NextGen Healthcare is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.