Associate Director, Revenue Cycle Management Optimization

Associate Director, Revenue Cycle Management (RCM) Optimization

We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.

The Associate Director, Revenue Cycle Management (RCM) Optimization manages and organizes revenue strategy activities to maximize cash flow through the creation of effective, scalable business. The incumbent in this role assists with the strategic alignment and oversight of claims assembly and submission processes. In close collaboration with Billing, Coding, IT, and Business Intelligence departments, gains insight and understanding of the organization's revenue streams to introduce, facilitate, and execute process improvement initiatives that drive best practices, achieve favorable collection of revenue, and minimize deficiencies in the revenue cycle process. The incumbent also serves as a subject matter expert on risk-adjustment and medical economics to aid in the development of revenue related products and tools.

Essential Job Duties / Responsibilities :

• Manages the development and implementation of revenue strategies to maximize profitability and value-based care outcomes.
• Develops and maintains internal controls to target revenue recovery throughout the organization by identifying operational, coding, billing, and reimbursement problems then recommending solutions.
• Evaluates and implements new technologies and systems to enhance revenue cycle processes.
• Facilitates and communicates optimization initiatives for improvements to the revenue management cycle.
• Works closely with RCM Operations leader to provide insights into areas of strategic focus.
• Collaborates with Product Management team to identify gaps in revenue management and subsequently designs products and tools to address these gaps.
• Partners with senior business stakeholders to identify, analyze, and prioritize RCM activities based on business value and urgency.
• Facilitates cross-functional collaboration and strategic alignment among RCM stakeholders, ABS Resources, and teams.
• Monitors and analyzes key performance indicators (KPIs) for assigned RCM functions, preparing regular reports for senior leadership.
• Leads change management efforts for new processes, technologies, and regulatory requirements within assigned areas.
• Supports the integration and alignment of revenue cycle management operational activities to drive standardization and streamline and increase operational efficiency.
• Ensures all critical business needs and requirements are identified and met with automated / manual processes.
• Stays informed of industry trends, regulatory changes, and emerging technologies in healthcare revenue cycle management, recommending best practices for implementation. Ensures compliance with all relevant healthcare regulations and standards.
• Manages payer data to determine denial and underpayment trends to accomplish business objectives. Manages internal data to determine leakage and gaps in the different business units.
• Monitors payer trends and identifies negative trends and then interfaces with payer representatives to resolve these issues.
• Conducts data processes and in-depth high-risk revenue analysis.
• Performs other duties as assigned and modified at manager's discretion.

Knowledge, Skills and Abilities :

Education and Experience Criteria :

Pay Range : $124,938 - $178,483 Salary

We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.

ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.