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MemorialCare · 3 hours ago

Executive Director Revenue Cycle

Fountain Valley, CA

Full-time

Onsite

Director/Executive

$180K/yr - $248K/yr

7+ years exp

MemorialCare is a nonprofit integrated health system committed to providing high-quality healthcare. The Executive Director Revenue Cycle will lead the strategy and operations of revenue cycle functions, ensuring compliance and optimizing workflows to enhance performance.

ChildrenHealth CareHospitalMedicalNon Profit

Responsibilities

Lead and manage end-to-end revenue cycle strategy and operations including patient registration and insurance verification (coordinate both functions with Operations), charge capture, coding, billing, claims management, denial resolution, and collections

Develop and implement strategic initiatives to improve revenue cycle performance, reduce denials, and enhance cash flow

Drive continuous improvement through data analysis, benchmarking, reporting, and adoption of best practices

Manage and monitor the execution of key performance indicators (KPIs), including:

Days in A/R

Net collection ratio

Gross collection ratio

Denial rate

First-pass resolution rate

Clean claim rate

Bad debt rate

Cost to collect

Patient collections rate

Credit balance resolution days

Patient satisfaction

Optimize and improve workflows to minimize cycle times, rework, and operating expenses, including automation and artificial intelligence where appropriate. Apply Lean Six Sigma principles and techniques

Ensure timely and accurate monthly reporting of KPIs and results to stakeholders and clients

Lead and manage a high-performing team of directors, managers, supervisors, and staff

Develop and prepare leaders and staff for advancement; ensure continuity of functional performance across personnel changes

Develop a culture of learning, growth, achievement, and accountability

Ensure compliance with federal, state, and payer regulations, including HIPAA, CMS, and commercial insurance requirements

Oversee coding optimization and compliance

Collaborate with IT and clinical operations to optimize EHR and practice management systems for revenue cycle efficiency

Partner with finance and accounting teams to support accurate financial reporting and forecasting

Serve as a liaison with external vendors, payers, and regulatory bodies

Collaborate with Nautilus accounting team regarding contract pricing and compliance for existing and new Nautilus clients

Coordinate with MCMG operations staff, provide program leadership of medical clinic front office staff related to revenue cycle functions such as registration, eligibility, etc

Serves as the primary liaison with Nautilus clients regarding escalated revenue cycle problem resolution. Develops and maintains positive relationships with practices utilizing Nautilus services

As invited, participate in MCMF’s Executive Management Team (EMT) meetings. Collaborate with other MCMF and MHS leaders in an effective manner

Keep abreast of changes in billing and reimbursement issues, new legislative programs, insurance, and regulatory requirements, etc. and ensures appropriate communication with stakeholders. Functions as the subject matter expert for professional billing issues

Qualification

Revenue cycle managementData analysisLeadership experienceLean Six SigmaHealthcare administrationFinancial reportingProblem resolutionCollaborationCommunicationTeam management