Manager Revenue Cycle

Employment Type:

Full time

Shift:

Description:

POSITION PURPOSE

Responsible for planning, directing, and managing support and day-to-day operational tasks for Trinity Health Medical Group (THMG) Revenue Cycle in a single or combined market/Health Ministry with annual net patient revenue less than $100M. Collaborates with and supports Medical Group operational leadership to ensure registration, insurance verification, authorization, financial assistance, and Point of Service cash collection processes are implemented and standardized across all locations to ensure top decile revenue cycle and patient experience performance.

Responsible for providing report development, analytical, process redesign and performance improvement support to providers and practice leaders as needed to support accurate, consistent, and compliant professional revenue operations. The Manager will have an A2 relationship to both the Regional Vice President of THMG RC Site Operations and the Regional or Local Finance/Operations leader.

ESSENTIAL FUNCTIONS

Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions. Manages Medical Group Revenue Cycle Site Operations for the Health Ministry, including proper implementation of system and local goals to ensure standard and top decile operations.

Collaborates with providers and ambulatory locations to improve revenue cycle performance by reviewing daily and weekly metrics, performing root cause analyses, and developing/implementing action plans to address. Understands the strategic and annual operational priorities for the Health Ministry; facilitates process improvement initiatives and department support as outlined in the annual operating plan. Manages the implementation of current and future best practices for revenue cycle functions to allow all practices to be efficient and market relevant, including overseeing the implementation and monitoring of adherence to payer contracts and procedures.

Provides effective use of system resources to drive optimal revenue cycle outcomes. Responsible for establishing partnerships with senior leadership at the HMs, THMG Finance leaders, Payer Strategies and EPFS Leaders to gain feedback, develop, and implement action plans to improve Front-End/Mid-Cycle Revenue Cycle processes that have a direct impact on billing and collections for account resolution. Manages the selection, direction, and development of new team members to ensure effective growth and utilization of talent.

Conducts performance appraisals for team leadership and oversees the cascading goals for the teams. Creates a culture that is supportive of personnel, fostering individual motivation, teamwork and high level of performance and accountability utilizing a participative management style to ensure colleague retention. Develops necessary infrastructure to achieve current and future departmental goals including organizational structure, staffing, policies and procedures, and implementation plans.

Manages in the selection and facilitation of appropriate process and technology training of colleagues to achieve technical proficiency, efficiency, regulatory compliance, and customer service in Revenue Cycle areas. Manages Health Ministry budgets and targets allowing for financial oversight of the THMG Revenue Cycle department functions. Develops capital and operational budgets to meet organizational goals and ensure appropriate allocation of resources to support current and future revenue operations for professional and ambulatory services.

Assures compliance to budget, as approved. Provides managerial oversight to payer credentialing staff (as applicable) to ensure new providers and ambulatory locations are accurately enrolled and credentialed with all Health Ministry contracted payers prior to providing patient services, when possible, to secure reimbursement for services and avoid credentialing-related denials. Oversight may include, but not limited to, local RSO Business Partners and Centralized Authorizations team members.

Ensures the successful integration of new physician practices and/or ambulatory services into the Health Ministry Revenue Site Operations. Ensures consistency in implementation of standard policies and procedures across all locations. Coordinates the technical planning for all new programs, departments or services that directly impact professional revenue site operations ensuring the systems to support are in place prior to implementation, e.g. new patient classes or location build in information systems.

Collaborates with THMG senior leadership and Finance leaders, Practice leaders, EPFS leaders, regional directors, regional clinical leadership, Hospital Site Operations, and colleagues to accomplish key performance goals, implement performance improvement via A-3 projects and other strategic initiatives, and identify opportunities for improvement through the integration of people, process, and technology. Accountable for key revenue cycle outcomes based on HM performance, in collaboration with local site leadership, Revenue Integrity leadership, EPFS leadership, System Office leadership, and other THMG Revenue Cycle Site Operations leadership, including but not limited to:

• Insurance Verification rate

• Authorization rate

• Upfront collections

• Denial rate

• Charge Lag

• Colleague quality and productivity

• Colleague Engagement and Satisfaction related to Revenue Cycle

• Patient Engagement and Satisfaction

• FY Budget Targets

Other duties as needed and assigned by the manager Maintains a working knowledge of applicable Federal, State, and local laws/regulations, the Trinity Health's Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

MINIMUM QUALIFICATIONS

Must possess a comprehensive knowledge of physician practice revenue cycle operations, revenue metrics and analytics, and revenue management, as normally obtained through a bachelor's degree in business or Healthcare administration or a related field, and five (5) to seven (7) years of progressive experience in revenue cycle operations, revenue metrics and analytics, and revenue management or an equivalent combination of education and experience. Minimum of three (3) years of management experience in a multi-facility, integrated health care delivery system or revenue cycle or consulting experience.

Knowledge of revenue cycle and accounting systems and insurance issues, healthcare industry issues and trends, legal issues in field of expertise, required third party and governmental guidelines, and work processing. Epic experience strongly preferred. Solid understanding of ICD-10 and CPT coding and medical terminology, with knowledge of federal, state, and payer-specific regulations relating to documentation and coding.

Exhibits strong leadership, integration, and execution skills with considerable experience in planning, formulating, and execution strategies with the ability to define program, process, or business objectives and scope, while also demonstrating proficiency and expertise to identify, evaluate and articulate operational opportunities, and risks, business needs/gaps, and understand customer/stakeholder interests. Must possess demonstrated knowledge of process improvement techniques and their application. Must possess ability to lead implementation and process improvement projects with minimal supervision.

Ability to manage multiple projects simultaneously. Demonstrates advanced analytical, evaluative, problem solving and decision-making skills to serve in managerial role in inspiring and initiating new ideas, determining strategies in the absence of guidelines, fostering innovative approaches to situations/processes/issues, and executing multiple critical assignments. Possess excellent written and verbal communication skills to effectively identify, assess, and facilitate improvements and resolution to present advisory, persuasive, and authoritative recommendation to all levels.

Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel. Maintains professional development and growth through journals, professional affiliations, seminars, and workshops to keep abreast of trends in revenue cycle operations and healthcare in general:

Participates as appropriate in continuing educational programs and activities that pertain to healthcare and revenue cycle management, as well as specific functional areas.

Develops and implements an annual plan of personal and professional development.

Participates in local, regional, and national health care revenue activities and professionally represents Trinity Health at these functions.

Serves in a leadership role and promotes positive Human Resource Management skills:

Fosters teamwork atmosphere between business and clinical stakeholders.

Retains, recruits, and manages staff to achieve strategic objectives; and

Provides staff training and mentoring.

Must demonstrate strong organizational skills leading a combination of direct and dotted-line reporting relationships. Exhibits strong, collaborative leadership qualities that can bridge across multiple disciplines.

Position is remote, however, must be able to travel approximately 25% of the time as may be needed in the HM. This may include travel to THMG locations outside of the HM and to System Office as may be necessary. Must be comfortable operating in a collaborative, shared leadership environment. Must possess a personal presence that is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

LEADERSHIP COMPETENCIES

As a Trinity Health Executive, the incumbent is expected to demonstrate leadership traits, which support our Mission Statement and Core Values as identified below:

Mission Statement: We, Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities.

Core Values:

• Reverence: We honor the sacredness and dignity of every person.

• Commitment to Those who are Poor: We stand with and serve those who are poor, especially those most vulnerable.

• Justice: We foster right relationships to promote the common good, including sustainability of Earth.

• Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care.

• Integrity: We are faithful to those we say we are.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

This position operates in a remote environment.

Incumbent communicates frequently, in person and over the phone, with people in all locations on product support issues.

Manual dexterity is needed to operate a keyboard. Hearing is needed for extensive telephone and in person communication.

The environment in which the incumbent will work requires the ability to concentrate, meet deadlines, work on several projects at the same time and adapt to interruptions.

Must be able to set and organize own work priorities and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles.

Ability to thrive in a fast-paced, multi-customer environment, with conflicting needs which some may find stressful. May warrant varied and/or extended hours, with changes in workload and priorities to keep pace with the industry and advance strategic priorities.

Must be able to travel approximately 25% of the time as may be needed in the region. This may include travel to THMG locations outside of the Region and to the System Office as may be necessary.

Must possess the ability to comply with Trinity Health policies and procedures.

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do.

Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve.

Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.