Coding and Clinical Documentation Improvement Manage

Responsible for Managing the Coding and CDI Programs

The Corporate Manager of Revenue Cycle Optimization will be responsible for owning performance improvement initiatives of SEHA Revenue Cycle Management. This position will implement strategic initiatives in partnership with the operational leadership across all SEHA divisions. The candidate will align initiatives across system roadmaps; facilitate workflow and process design efforts, partner on systems integration strategies, and other non-functional requirements for the non-clinical systems across the enterprise. The role will supervise implementation teams for each of the functional areas they own, and partner closely with SEHA leadership, test teams, and other operational stakeholders in the organization. On large enterprise initiatives, this person will coordinate all Revenue Cycle Management and will be a pivotal player in delivering the next generation Revenue Cycle performance improvement to SEHA. This role will collaborate as the leaders of the Revenue Cycle Management Team to effectively lead strategic initiatives. The position ensures the Revenue Cycle program is on the correct planning path and timing schedule, and has the visibility and support necessary to successfully implement. The candidate will be accountable and responsible for ensuring success of the Revenue Cycle performance improvement. The role is responsible for supporting the growth and successful execution of revenue cycle transformation. Ensuring successful new business on-boarding to include: implementation, workflow management including arranging for content, technology, and meeting targets. The position will provide oversight and operational guidance to the day to day operations of Revenue Cycle Operational departments and activities involved in the revenue cycle. Functions that would need financial guidance from this position are Patient Access, Patient Financial Services, Revenue Recovery, Revenue Integrity, Revenue Cycle Analytics, Hospital Operation and Applications.

Provides strategic direction for Revenue Cycle processes, including Patient Access, charge master description, revenue cycle reporting, charge capture process, denial management and related functions through quality data, policies, and efficient procedures. Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of job role or practice. Participates in ongoing quality improvement activities. Maintains compliance with organization's policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards. Identifies opportunities for process improvement, and implements them by engaging stakeholders throughout the organization. Drives for changes in work products and processes that will improve functional area efficiencies and effectiveness. Coordinate, motivate and follow up with all stakeholders & resources to ensure project progresses is on schedule and goals and requirements are met; Identify, access and resolve complex business problems/issues/risks and facilitate issue resolution and risk mitigation. Works with SEHA leadership to assist, define, and document high level program target dates and projects across a 1-3-year roadmap. Guides the project teams through the design, build, and implementation phases of the Revenue Cycle organizational improvements. Develop work-plan as defined by assessment process and benchmark activities Determine / develop business results metrics, modeling current / future business processes, gathering business requirements and identifying the organizational changes required to successfully realize the benefits of the solution Target revenue recovery efforts throughout the reporting areas by analyzing problems and implementing solutions Monitor receivables efficiencies establish goals and measure performance Manage and maintain business relationship with Hospital Management / Revenue Cycle business partners to maximize continued gain-sharing operation Partner with Information Technology and Hospital Revenue Cycle/Financial Operations management for reporting purposes and opportunities awareness Initiate projects focused on improving work flows specific to financial outcomes for increase revenue realization Analyze Hospital financial reports for opportunities and recommend/ implement key indicators and best practice for enhancements, process improvement or resolutions for increased results Coordination/ Liaison with hospital business partner and steering committee as well as apply innovative solutions to increase cash and decrease cost. Expertise in monitoring efficiencies with Dashboard reporting

Leads and manages Revenue Cycle projects, working with key stakeholders.

Coordinates and implements revenue cycle initiatives, including identifying and assembling resources when necessary.

Complies with organizational and regulatory policies for handling confidential information. 

Maintains revenue cycle KPI's within established industry standards and instills accountability and ownership at the appropriate level.

1. 1. Bachelor degree in Nursing, Medical, Allied or any Healthcare. -Preferred
2. 3. Coding or CDI certifications mandatory;

2. Healthcare Certifications-Preferred

Required:

Bachelor in Accounting, Finance, Business Administration or Healthcare.

Desired:

Master's in Business Administration or Healthcare 

One Or More Certifications Required:

1. Cdip-From Ahima

1. 2. CCDS- from ACDIS
2. 3. Any coding certificate as approved from AHIMA (e.g.: CCS) or AAPC (e.g.: CPC).

Required:

Desired:

Healthcare Certifications preferred (CHFP, CHAM, CHRI, and/or CMPE)

Lean Six Sigma Certification

7-10 Years

• RCM 1. At least 3 years experience in coding/CDI function
• 2. At least 3 years experience in RCM function
• 3-5Years (Proven track record of supervisory/managerial experience)

Required:

5+ years of healthcare provider experience with Revenue Cycle domain expertise Demonstrated ability to deliver operational results and solid process improvement experience.

Extensive knowledge of healthcare revenue cycle systems.

Ability to coordinate and monitor audits when necessary.

Experience with hospital financial and patient accounting systems, such as Cerner;

Superior critical thinking, analytical and problem-solving skills;

Ability to lead cross-functional teams in Discovery and Development;

Ability and track record in creating a collaborative work environment between Hospital business office employees and on-site PM Advocates to enhance business operations, productivity and effectiveness;

Desired:

Project Management experience and 10 years of Revenue Cycle Experience if lieu of degree