• Job Description

  Req#: R2328124

  If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.

  Day - 08 Hour (United States of America)

  This is a Stanford Health Care job.
  
  A Brief Overview
  The Executive Director Mid-Revenue Cycle is responsible for strategic leadership and direction for the overall operations of the mid-revenue cycle operations for the Health System. Responsible for providing strategic planning, leadership, and operational support for the management and ownership of the professional fee schedule, hospital Charge Description Master (CDM), Strategic Pricing, hospital and professional coding, mid-revenue cycle optimization and the Clinical Documentation Integrity Program. Plans, directs and assumes accountability in coordinating, monitoring, and analyzing of charge triggers, controls and reconciliation, as well as coding for purposes of compliant billing and charging procedures. Prevents recurrence of issues that can cause revenue leakage, revenue degradation and compliance risk. Develops strategies to optimize professional and technical (hospital) revenue capture through the integration and management of staff for each clinical area. Ensures compliance with third party payer requirements and applicable laws and regulations. Oversees efforts to ensure timely response and compliance with regulatory agencies. This position works in close collaboration with all Revenue Cycle and charge-generating departments, School of Medicine Leadership, Clinical Operations Leadership, Managed Care Contracting, Controller's Office , Finance and the Corporate Compliance Officer for all SHC entities.
  
  Locations
  Stanford Health Care
  
  What you will do

  • Plans, organizes, and directs the development and implementation of new policies, new roles for staff, new workflows and processes that assures that every process that affects revenue capture and clinical documentation is effective in optimizing all Technical (hospital) and Professional revenue. Acts a liaison with each Director of Finance and Administration (DFA), Clinical Chief, Division Chief presenting on the total revenue picture and its management for their respective clinical areas.

  • Plans, organizes and develops an unified, multidisciplinary, outcome-focused clinical documentation improvement program in executing tactics for analyzing outcomes, prioritizing improvement efforts, and communication of expected practices and processes.

  • Provides overall strategic direction and leadership to all mid revenue cycle operations through the health system.

  • Builds and support effective relationship with internal and external stakeholders and organizations. Develops partnerships, coordinates activities, review work, exchanges information, and/or resolves problems related to revenue integrity/revenue cycle programs and continuous improvement initiatives.

  • Directs and participates in the development, implementation, and consistent application of effective organizational policies, procedures, and practices. Develops and support internal controls to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective an efficient, and compliance with current laws and regulations is achieved.

  • Communicates the department vison, translating it into actionable projects and activities. Maximizes management staff’s contributions and assures timely decision-making reflecting the mission, vision and values of the health system.

  • Participates as a subject-matter expert and may lead or facilitate task forces, teams, and/or councils to plan, implement and coordinate programs, services, and/or activities for the organization.

  • Leads and coordinates with the Controller’s Office, Finance and Managed Care the enterprise-wide complex strategic pricing analysis to support contract negotiations for all managed care payer contracting initiatives.

  • Provides strategic guidance to Manage Care and other senior management leaders in identifying optimal pricing strategy to maximize value to the organization.

  • Identifies metrics and performance goals for revenue capture, hospital and professional coding and CDI. Metrics are set for each level of staff and team performance.

  • Works collaboratively with Revenue Cycle leadership to define and implement tactical efforts in order to achieve Revenue Cycle's Strategic goals.

  • Defines the criteria for reporting that supports active daily management. Works closely with the IT Director of Reporting to design reports that are relevant to the Chiefs and DFA’s for each Clinical area. Communicates information strategically, delivering results-oriented messages.

  • Meets regularly with Chiefs of Service, DFA’s and Finance peers to assure that all aspect of revenue capture is well managed in order to achieve the optimization of revenue.

  • Meets regularly with peers in Ambulatory Care, Cancer Center and other revenue producing departments to assure appropriate synchronization between clinical activity, , revenue capture and clinical documentation.

  • Ensures compliance with federal and state laws pertaining to the revenue capture and reimbursement.

  • Directs and coordinates communication with Information Technology to ensure appropriate systems, enhancements, and tools are utilized to effectively manage day to day Revenue Integrity operations

  • Evaluates purchases, contracts and services provided by external vendors to ensure best pricing and effective results (external vendors, reference tools, software tools, etc.), including ongoing vendor performance monitoring and issue resolution

  • Prepares organizational leadership to recognize and mitigate risks brought on by organizational changes

  
  Education Qualifications

  • Bachelor’s Degree in a work-related field/discipline from an accredited college or university.

  
  Experience Qualifications

  • Ten (10) years of progressively responsible and directly related work experience and work experience in an administrative and/or managerial positions.

  Required Knowledge, Skills and Abilities

  • Ability to interact with C level executives and present IT perspectives, roadmaps and strategies for increased efficiencies.

  • Detailed knowledge and expertise across the entire hospital and professional revenue cycle continuum.

  • Strong executive presence, including communication skills that enables and appreciates other perspectives and the ability to offer compelling insights and recommendations.

  • Outstanding management abilities and a demonstrated track record of leadership.

  • Capability to serve as both a leader and a coach with demonstrated ability to work as a team or independently.

  • Thorough understanding of healthcare financial trends and financial systems/tools.

  • A proven leader with significant revenue cycle experience to lead the integration of all mid revenue cycle process.

  • Demonstrates a desire to provide guidance in order to help direct reports achieve growth, established goals, and desired outcomes.

  • Skilled in leading change management to implement new and “best practice” approaches to business processes to improve customer service, operational effectiveness and financial outcomes.

  • Exhibits strength of character to champion risk taking; a self-starter and self-motivated.

  • Understanding of clinical document improvement (CDI) principles.

  • A true collaborator, that can influence by actively listening and bringing multi-disciplinary teams (clinical operations, care providers, administration, etc.) together.

  • Strong understanding of information technology and its applications in revenue cycle management.

  • Demonstrated ability of strong written and verbal communication skills and the ability to make persuasive presentations to key internal and external stakeholders, senior leadership, peers and board members. Ability to communicate and listen effectively at all levels of the healthcare organization, internal as well as external.

  • Demonstrates knowledge of various payment and coding systems, particularly the Outpatient Prospective Payment System (OPPS), DRG's, MediCal APG Grouper, HCPCS and CPT-4 coding schemas.

  • Knowledge of Medicare, Medicaid and other third-party billing coverage and compliance issues.

  • Knowledge of CMS and State coding standards and charge capture (technical and professional) guidelines.

  • Knowledge of Medicare documentation sources and regulatory guidelines.

  • Understands financial management and health care reporting, including the relationship between the CDM, charging, coding and billing.

  • Ability to develop long-range business plans and strategy.

  
  Licenses and Certifications

  • None

  These principles apply to ALL employees:
  
  SHC Commitment to Providing an Exceptional Patient & Family Experience
  
  Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.
  
  You will do this by executing against our three experience pillars, from the patient and family’s perspective:

  • Know Me: Anticipate my needs and status to deliver effective care

  • Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health

  • Coordinate for Me: Own the complexity of my care through coordination

  #LI-RL1

  Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

  Base Pay Scale: Generally starting at $97.01 - $128.53 per hour

  The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.

• About the company

  Stanford Health Care delivers the highest levels of care and compassion. SHC treats cancer, heart disease, brain disorders, primary care issues, and many more.

Notice