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Director of Revenue Cycle Management (RCM) - 869733

Pathways

Director of Revenue Cycle Management (RCM) - 869733

Fredericksburg, VA
Full Time
Paid
  • Responsibilities

    Are you interested in working with a company that values people and has a passion for service? Do you want to become part of an organization that cares about your personal and professional growth? If you have answered YES to these questions, then you should consider working for Pathways!

    Pathways is one of the largest national providers of accessible, outcome-based behavioral and mental health services. At Pathways, we deliver exceptional value by creating healthier communities through the work of exceptional people. Our more than 6,000 employees provide the highest-quality home- and community-based human services in 20 U.S. states and the District of Columbia.

    Pathways is seeking a dynamic Director of Revenue Cycle Management (RCM) to join our team. This position leads and directs revenue cycle functions, aligning them with best-in-class performance metrics in specific categories of revenue cycle (productivity, compliance, accuracy, effectiveness, and efficiency). The role is responsible for establishing, meeting and exceeding operational work flow, productivity and results standards related to the above functions; participates in the development and implementation of a revenue cycle integration model (EHR) that coordinates and aligns the resources deployed to revenue cycle functions across the section(s) in efforts to build consistency of work flow and optimization of resources. The Director, Revenue Cycle Management, will assist with EHR development and alignment (Billing & AR) as well as determining standard RCM EHR configurations with a focus on efficiency, quality control and loss reduction. The position also organizes, manages, and monitors the performance productivity of staff in revenue cycle roles.

    Reporting to the Vice President, Finance, Dir/RCM must have a thorough understanding of the entire revenue cycle process, including front-end enrollment and point-of-care processes. This position will be required to provide narrative/policy & procedure creations. The Director/RCM will provide leadership and partner with Operations to set priorities for multiple teams responsible for billing of claims, creation and management of pre-adjudication edits and follow-up/account resolution activities.

    Qualifications:

    Bachelor’s Degree required

    Master’s Degree in Healthcare Administration or Business Administration Preferred

    Minimum of 5 years in a supervisory/management role required.

    Previous behavioral health (clinical, ancillary, and/or billing) experience preferred.

    Experience with EHR and practice management software required, behavioral health EHR preferred.

    Job Duties:

    Define strategic objectives, work closely with internal stakeholders and business partners to evaluate and analyze existing systems and processes, then implement improvements that support revenue cycle goals

    Develop best practice methodology for system and process optimization on a national scale

    Evaluate and recommend optimal revenue cycle organizational structure. Establish transition plan and manage the deployment of plan

    Establish and implement standard metrics to monitor revenue cycle including revenue outstanding, cash as a percentage of net revenue and net collectible value, conversion rate, denial rate, unbilled, etc.

    Working in collaboration with the RCM Compliance Team, develop a regulatory compliance program to periodically test and evaluate compliance with federal, state and local laws related to billing and collection activities. Lead remediation activities as needed

    Assist with EHR/revenue cycle management software evaluation, selection, and implementation

    Work closely with IT to develop analytics dashboard and integrate multiple systems to produce real-time data for operational, managerial, and executive leadership including revenue, projected revenue, projected cash collection, productivity, denial metrics, etc.

    Build external relationships among vendors and industry leaders that enhances the company performance and reputation among the provider community

    Establish corporate common language and standard for service delivery, licensing, and accreditation as it relates to revenue

    Pathways is committed to creating the best possible work environment for our team members and offers the following total rewards package: (NOTE: THIS ONLY APPLIES TO FULL TIME EMPLOYEES)

    Competitive Salary

    Paid Vacation Days

    Paid Sick Days

    Holidays

    Medical, Dental, Vision including a Health Savings Account

    Health, Dependent and Transportation Flexible Spending Accounts

    Basic and Optional Life Insurance for Employee, Spouse and/or Dependents

    401 K with employer contribution (“50% of the first 6% of eligible compensation up to an annual maximum of $750”)

    Mileage & Cell Phone Reimbursement

    Training, Development and Continuing Education Credits for licensure requirements

    Opportunities for advancement! As we grow, you grow with us!

    Pathways or any its subsidiaries does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status or any other characteristic protected by law. Pathways is an Equal Opportunity Employer and a Drug Free Workplace.