Senior Director of Revenue Cycle and Managed Care

Cook County Health and Hospitals
United States, Illinois, Illiopolis
Nov 16, 2024
Job Summary The Senior Director of Revenue Cycle and Managed Care (Senior Director} will be responsible for organizing Managed Care and Revenue Cycle initiatives, staff and resources to maximize revenue received by Cook County Health (CCH) for the provision of clinical services including inpatient care and outpatient services. The Senior Director will focus activities on internal program operations and collaboration with clinical and operational leadership. The Senior Director designs a system to support the patient's financial interface across the continuum of care, using best practices of cash collection and posting, registration, insurance verification, billing, and managed care reimbursement principles. This position is exempt from Career Service under the CCHHS Personnel Rules. General Administrative Responsibilities Collective Bargaining Review applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposals Participate in collective bargaining negotiations, caucus discussions and working meetings Discipline Document, recommend and effectuate discipline at all levels Work closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining Agreements Initiate, authorize and complete disciplinary action pursuant to CCH system rules, policies, procedures and provision of applicable collective bargaining agreements Supervision Direct and effectuate CCH management policies and practices Access and proficiently navigate CCH records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreements Management Contribute to the management of CCH staff and CCH' systemic development and success Discuss and develop CCH system policy and procedure General Administrative Responsibilities continued Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining Agreements Work with Labor Relations to discern past practice when necessary Typical Duties Using available data sources, designs a mechanism to collect, interpret and take action for program and process parameters. Uses common improvement methodology e.g. Plan-Do-Study-Act (PDSA) to address programmatic areas not achieving performance targets. Investigates and evaluates approaches e.g. methodological, technical to improve efficiency and effectiveness for areas of responsibility. Supports the accurate translation of payer requirements (Governmental or Commercial) into workflows or metrics. Provides periodic reports to senior leadership on selected aspects of revenue cycle, impact of process changes and opportunities to reduce cost or denials. Works across departments and wide range of staff to support revenue cycle goals. Provides reports to clinical leadership on achievements and opportunities in the areas of documentation, charge capture and compliance with managed care requirements. Works collaboratively to identify solutions. Supports the provision of answers to financial or benefit related questions that are consumer centric and responsive. Understands and keeps current with changes in managed care third party reimbursement that may have an impact on revenues received and provides recommendations on strategy. Provides day-to-day oversight and leadership to Patient Access, Revenue Cycle and Managed Care. Oversees negotiation of payer and managed care contracts to ensure best outcomes for the system. Monitors performance of approved managed care contracts. Facilitates reporting for leadership that shows how the system is maximizing revenue while adhering to all regulatory requirements. Ensures billing practices meet or exceed industry standards. Participates in discussions or activities regarding medical staff providing services at other institutions and will ensure this will provide maximal benefit to CCH. Participates in discussions with external entities regarding partnerships or other joint venture activities to identify revenue generation activities that will be beneficial to the health system. Performs other duties as assigned Reporting Relationships Reports to the Chief Financial Officer, CCH Minimum Qualifications Bachelor's degree in business administration, health administration or finance from an accredited college or university * Seven (7) years of experience in financial management or administration for an integrated health system Three (3) years of experience with third party billing related activities for Medicaid, Medicare and Commercial Managed Care contracts Three (3) years of supervisory and/or managerial experience Three (3) years of experience in a safety net or teaching hospital Advanced proficiency In Microsoft Office Excel Preferred Qualifications Master's degree in Business or related field from an accredited college or university Project management experience Electronic Medical Record experience, such as CERNER or EPIC Experience in Program or service implementation and performance improvement Knowledge, Skills, Abilities and Other Characteristics Knowledge of third-party billing related activities for Medicaid, Medicare, and Commercial Managed Care contracts Knowledge of Healthcare and Family Services (HFS) regulations Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups Demonstrate attention to detail, accuracy and precision Demonstrate analytical and organizational, problem-solving, critical thinking and conflict management/ resolution skills Ability to explain complex concepts to a diverse audience Ability to support staff during periods of change and/or workflow Ability to translate conceptual (e.g. new HFS regulation) into action plan for area of responsibility Ability to organize priorities *and workflows to meet deadlines and project targets. Physical and Environmental Demands This position is functioning within a healthcare environment. The incumbent is responsible for adherence to all hospital and department specific safety requirements. This includes but is not limited to the following policies and procedures: complying with Personal Protective Equipment requirements, hand washing and sanitizing practices, complying with department specific engineering and work practice controls and any other work area safety precautions as specified by hospital wide policy and departmental procedures. The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of the personnel so classified. For purposes of the American with Disabilities Act, "Typical Duties" are essential job functions. Interested Candidates should send a CV and cover letter to: mgmtrecruit@cookcountyhhs.org Cook County Health is an equal opportunity employer.