VP, Revenue Cycle Operations (AHN)

Company: Highmark Health
Location: Pittsburgh
Posted on: September 13, 2020

Job Description:

Thank you for your interest in employment at a Highmark Health company. Highmark Health uses an online application process. If you participate in the online application process through this Workday site, your personal information will be collected, including but not limited to data such as your resume and resume content, education, contact information, address, city, postal code, country, phone number, email address, IP address, as well as any other personal information you choose to provide. As part of the online application process, we will provide details such as how we will use the data that we collect and where such information is processed. We will also ask for your consent to use the data for purposes contained in the Highmark Health Data Protection Statement and the GDPR Data Protection Consent for Job Applicants, and for all other permissible purposes.

This job is responsible for maintaining and enhancing a high functioning and patient-centric hospital and physician revenue cycle leading a cross-departmental organizational structure. Revenue Cycle functions include Patient Access (including admitting, registration, pre-services, case clearance), Clinical Revenue Cycle (including HIM, coding and Revenue Integrity), and Central Business Office (including billing, follow up, credit and collections, cash management, customer service). The role will be focused on business office functions.

ESSENTIAL RESPONSIBILITIES:

Provides leadership and administrative direction to Directors of HIM, Patient Financial Services, Registration and Financial Analysis and supporting staff. Mentors, develops and encourages these individuals to reach their full potential as embodied in the organization's Core Values. Incorporates the values and standards of WPAHS into all business staff development practices and all departmentally directed activities. Ensures employees are hired, trained and evaluated according to the standards set forth by Human Resources and sound management principles.

Maintains appropriate internal control safeguards over A/R records and collection of cash. Maintains compliance standards for providing accurate information on all facility or health system billings. Plans, coordinates and prepares year-end audits with public accounting firms and third party auditors as they relate to A/R operations. Ensures compliance with relevant regulations, standards and directives from regulatory agencies and third party payers.

Oversees and enhances the development of the data collection, analysis and reporting processes for the executive management of the revenue cycle at all WPAHS facilities, including information integrity validation and interpretation. Oversees the financial interface between and performance analysis of the patient financial services functions and fiscal services functions

Assesses and responds to organizational and customers' needs with innovative programs to ensure customer satisfaction. Assists with ensuring cost effective and efficient processes and outcome management for internal and external customers. Maintains a collaborative and supporting relationship with other management staff at all systems facilities and encourages subordinates to do likewise to ensure integration of patient processes that will achieve optimal patient outcomes.

?Ensures that goals for A/R days, cash, and bad debt management are accomplished as well as maximizing the net revenue collectability from all third party payers. Participates in financial forecasting and planning along with other members of the management team. Ensures completion of various financial forecasts including cost center salary and direct expenses, month-end financial reporting, receivable levels (days in A/R and aging), cost center productivity, and any long range and strategic plans for the department.

QUALIFICATIONS:

Minimum

Bachelor's degree in Management Accounting, Finance or other related specialty

10 years of progressive experience with 5 years at the supervisory/management level

Advanced analytic skills and experience in developing outcomes-driven metrics and Service Level Agreements

?Experience with responsibility for a large (at least 250+) group of employees

Hands-on experience in various areas of patient access, registration, billing, credit and collection, and cash management

Preferred

MBA

Multi-hospital experience

Epic experience

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

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Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network.

Based in Pittsburgh, Pa., Highmark Health’s 35,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services.

Highmark Health’s businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.

Keywords: Highmark Health, Pittsburgh , VP, Revenue Cycle Operations (AHN), Other , Pittsburgh, Pennsylvania