Director, Revenue Analytics jobs in United States
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Adventist Health · 17 hours ago

Director, Revenue Analytics

Adventist Health is a faith-based, nonprofit, integrated health system serving over 100 communities. The Director of Revenue Analytics leads the Revenue Management department to maximize reimbursement and reduce denials through data-driven insights and collaboration across various healthcare functions.

Elder CareHealth CareHospitalMedicalNon ProfitWellness

Responsibilities

Directs the weekly High Dollar Review process across multiple hospitals, coordinating with Patient Access, Case Management, Utilization Management, Billing, Patient Financial Services, and other revenue cycle disciplines to surface systemic gaps and improve reimbursement. Leads denial management strategy, including root cause analysis, denial prevention initiatives, and tracking resolution performance across all payer types
Coordinates with all stakeholders to ensure timely appeal submission and to strengthen payer accountability for overturning inappropriate denials. Monitors denial trends to identify systemic issues and drives corrective action to improve reimbursement outcomes. Identifies and removes barriers to clean claims, timely payment, and full reimbursement
Serves as key liaison between Finance, Payer Relations, Case Management, Utilization Management, and Revenue Cycle to ensure contracts are optimized, compliance maintained, and reimbursement risk mitigated. Collaborates in payer escalation and Joint Operating Committee forums, presenting data-driven cases to secure authorization processes, correct DOFR misalignments, and resolve denials
Oversees contract performance analytics, ensuring payer adjudication aligns with negotiated terms and flagging discrepancies. Reviews Aged Trial Balance (ATB) to identify reimbursement risks by payer behaviors, service line, and internal deficiency trends. Assists the Finance team to prepare and analyze AR Reserve, identifying trends that significantly impact net revenue
Builds, coaches, and mentors a high-performing analytics team that integrates clinical and financial insights to improve net revenue yield. Ensures timely completion of performance reviews, orientation, compliance training, and continuing education for staff. Maintains a supportive work environment through effective selection, orientation, management, and staff development. Interviews, hires, and trains employees in a timely manner
Performs other job-related duties as assigned

Qualification

Revenue Cycle ManagementA/R ManagementManaged Care ContractingData AnalysisLeadership ExperienceTeam BuildingCommunication SkillsProblem Solving

Required

Bachelor's Degree or equivalent combination of education/related experience: Required

Preferred

Master's Degree: Preferred
Seven years' related experience in A/R Management and/or Managed Care contracting and analysis, as well as experience directing a business office: Preferred
Five years' leadership experience: Preferred

Company

Adventist Health

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Adventist Health is a Adventist Health is a not-for-profit health care organization .

Funding

Current Stage
Late Stage

Leadership Team

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Gwen Mathews
CEO Ukiah Valley Medical Center, SrVP Operations AH Northern Cal Network
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Kerry L. Heinrich
President and CEO
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Company data provided by crunchbase