Vice President, Revenue Cycle and Managed Care

At Solis Mammography, our patient-focused culture is at the heart of every interaction. We deliver the care, compassion and high-touch experience that have made us a valued healthcare partner to the generations of women that we serve. As the nations leader in breast health services, our commitment to providing excellence in patient care is realized at every level of our organization. The Solis Revenue Cycle team is establishing a dynamic culture of work hard, play hard and is looking for the next all-star to add to its roster. If you are an ambitious self-starter who thrives in an environment where you are empowered to take ownership of your area of responsibility, we would like to speak to you.

Reporting to the Chief Financial Officer, the Vice President of Revenue Cycle and Managed Care is responsible for providing oversight of revenue cycle operations as well as the managed care contracting function for Solis Mammography. This position will lead Solis revenue cycle models, outsourced and internal, and our JV business partners to maximize our collections. Responsible for providing the vision, leadership, planning and management for the development, implementation and support of contract negotiations, documentation and relationship management. Advises and provides guidance to other emerging markets on contracting standards and negotiations, and recommended strategies, as well as involvement in specific negotiations and documentation.

The VP will work with Solis leadership, operations departments and the accounting team, in addition to the third party providers (Parallon, future hospital systems, and all outsourced revenue cycle vendors). This position is responsible for oversight of performance metrics including actual vs expected collection. The VP will be responsible for implementing policies and procedures in accordance with legal and compliance requirements.

RESULTS MEASURED BY THE FOLLOWING RESPONSIBILITIES:

• Understands, promotes and demonstrates the Solis Way
• Leads the current in-house revenue cycle operations including patient accounts and insurance verification staff. Provide direction and guidance that fosters a high-performing team environment through training, managing to metrics and development.
• Leads managed care initiatives and oversees the organizations contract agreements by developing contracting strategies to ensure successful negotiation and execution of agreements.
• Guides the Managed Care Director to develop overall payor and network contracting strategies for business growth, maximum revenue and maximizing the organizations competitive cost structure.
• Manages and analyze the metrics of the revenue cycle operations and drive the consistent reporting across the revenue systems. Work with the accounting team to ensure the alignment of revenue recognition and the reserving or oversight of bad debt and write-offs.
• Analyzes accounts receivable and collection data and extract it into meaningful presentations and actions. Identify the issues and action plans to address.
• Manages the effective communication with Solis business partners across all revenue cycle functions
• Develops and maintains external professional relationships with payers, professional associations, regulatory agencies and other healthcare organizations to monitor and influence.
• Monitors revenue cycle performance metrics to drive continuous improvement efforts in all areas of the revenue cycle providing regular updates to the CFO and Controller to ensure prompt attention to areas of concern.
• Leads the technology strategies of the revenue cycle.
• Leads the integration and act as a business partner to our JV hospital systems as it relates to their billing and collection on behalf of the JV.
• Monitors, takes action and communicates issues on bad debt reserves, contractual and write-offs.
• Develops the revenue cycle operational and budgetary decisions.

SKILLS/QUALIFICATIONS:

• A proactive problem solver. Ability to understand and deal effectively with issues and opportunities

• Ability to understand major objectives or goals and break them down into meaningful action steps
• A change agent and capable of guiding organizational leaders in initiating various change management initiatives with the view of leading and guiding the organization towards the future revenue cycle model

• Superior judgment, negotiation, and decision-making skills

• Strong communication skills in both written, and verbal/presentation

• Extensive knowledge of Medicare, Medicaid, and general third-party payer - billing and follow-up practices

• Proven ability to motivate, manage, coach and mentor both supervisory and staff level team, members

MINIMUM EDUCATION & EXPERIENCE REQUIREMENTS:

• Ten (10) years of experience in a revenue cycle capacity is required (acute setting or multi-physician practice is preferred)
• Ten (10) years of experience negotiating healthcare contracts; provider network management/development and/or management in a managed care is required.
• Minimum ten (10) years of relevant, progressive experience in a management role is required.
• Bachelors degree in healthcare administration, business or other related fields is required.
• Full revenue cycle experience from beginning to end including but not limited to: net days sales outstanding; AR aging; cash collections as a percentage of net patient revenue; denial rates; favorable customer service scores; net revenue discharge; bad debt as a percentage of net patient revenue is required.
• Strong background in provider network management, financial management and knowledgeable of federal and state laws and requirements relating to healthcare management is required.