Region Director Revenue Cycle

Job description

Job Summary and Responsibilities

As our Regional Director Revenue Cycle you will serve as the preeminent revenue cycle leader for the Physician Enterprise (PE) California Region, charged with orchestrating the financial revenue cycle integrity and operational success of a complex, multi-site physician organization. This division encompasses 1,200+ providers billing under DHMF/PHC, generating over $2.3B in annual Gross Revenue, and the role also provides critical billing agency services for California Hospital-owned and managed RHC, 1206(d), and 1204(a) physician clinics, representing an additional $24M in annual Gross Revenue. Reporting directly to the DHMF CFO/CA Regional VP of Finance, the Regional Director acts as a high-level strategic advisor, influencing key business decisions and shaping the revenue capture outcomes of the organization.

Every day you will be responsible for the planning, development, and execution of systematic workflows that maximize revenue realization and optimize cash flow. This encompasses the entire end-to-end revenue cycle—from registration and charge capture to complex insurance/patient collections, contract analysis, and reimbursement strategy. In an era of rapid digital and structural transformation, the Regional Director will lead in a rapidly changing environment. A pivotal aspect of this role involves leading the division through a transition to the Epic billing system and orchestrating a seamless go-live while simultaneously managing the high-priority project of legacy A/R rundown within the IDX business system. You will be accountable for ensuring that all revenue cycle functions including billing, coding, and denial management align with federal/state regulatory guidelines (including Medicare/Medicaid) and organizational mission. Furthermore, the Regional Director represents the PE West Division on CommonSpirit national committees, bridging the gap between national strategy and regional execution to drive standardized performance, continuous improvement, and the long-term financial sustainability of the organization.

To be successful in this role, you will possess deep expertise in Epic-based revenue cycle management, the ability to create a culture of pride, compliance, and relentless accountability, superior communication skills and excellent analytical skills to identify performance trends and implement solutions.

As a remote employee, we will provide you with the equipment needed to work from home, including a laptop, docking station, dual monitors, and accessories.

This position is remote, working PST businses hours. Periodic onsite activities may be required.

Plan and direct revenue cycle management team with strategic vision. Directing the implementation of key strategies through the revenue cycle management team; fostering an environment of accountability to create a high performing team. Leads evaluation and integration of revenue cycle functions. Developing and executing a work plan that increases coordination and optimization across the revenue cycle.

Establishes expectations and plans, sets priorities, and oversees processes to measure, systematically assess, and implement improvements to maintain achievements within the department. Compiles, analyzes, and documents data and outcome measurements and submits to the appropriate departments/committees.

Develops departmental strategies to meet cash projection formulas, reduce days in Accounts Receivable, and reduce denials. Develops and utilizes advanced monitoring and reporting techniques and systems to monitor revenue cycle key performance indicators. Evaluates and advises on the impact of long-range planning from introduction of new clinical programs/strategies and associated regulatory actions.

Leads efforts in monitoring and researching regulatory changes and proposes actions to respond to changing legislation/regulations. Assess and respond to current and future internal and external healthcare trends to establish and ensure the necessary direction for revenue cycle activities. Proactively track and respond to market dynamics associated with reimbursement.

Assists in identification of new technologies that will improve departmental operations. Effectively manage and lead vendor management program, in collaboration with PE Rev Cycle leadership, to ensure vendor performance is optimized while evaluating marketplace options.

Direct the analysis, reporting and recommendations for key performance metrics including billing, collection and accounts receivable results such as A/R aging, volumes and trends to Senior Management and Revenue cycle management and staff. Works closely with Accounting and Finance teams to ensure accurate and relevant G/L reporting. Review monthly performance and associated key indicators.

Job Requirements

Required

Ten or more (10+) years of increasing healthcare revenue cycle management experience in Multi-Specialty, Physician billing

Must have business office and/or patient financial services experience with Medicare, Medicaid and commercial billing, patient registration, and coding

Bachelors degree or equivalent combination of education and work experience

Knowledge of Key Performance Indicators (KPI’s) across revenue cycle spectrum and experience with implementing and managing effective performance outcomes

Excellent analytical skills with a proven track record in identifying performance trends and implementing solutions

A team builder with a track record in formulating revenue cycle policy, developing and implementing operational plans new strategies and procedures

Strong technical understanding and appreciation for the automation of all functions related to the revenue cycle

A solid understanding of system and business processes, as well as healthcare financial issues

Excellent communication skills – including written, oral, presentation and listening. Ability to communicate effectively at all levels of the organization with proven experience in relationship building onsite and with remote locations

Ability to build effective teams and provide coaching, guidance and support, set professional development plans to assist employees to reach their full potential through the Performance Management process

Ability to understand priorities and set short and long term department goals

Ability to develop and implement strategies to meet goals

Ability to develop systems, processes and policies to support the achievement of goals in a cost effective manner

Working knowledge of Google Suites, Athena IDX BAR, SCHED, FRM and other modules, Epic, CernerPCA, Optum Claims Manager, Experian Eligibility and Contract Manager, HealthLogic

Preferred

Fifteen or more (15+) years of increasing healthcare revenue cycle management experience in Multi-Specialty, Physician billing preferred

Knowledge and experience in HMO contracting and payment mechanisms preferred

Experience in complex regional/ shared service environment with multiple/ matrix reporting relationships preferred

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Worksite address

rancho cordova, CA, 95741, US

Who can apply

Review the original listing for work authorization, qualifications and employer requirements.