POSITION SUMMARY: 

Responsible for driving revenue cycle initiatives and operations in a given Kaiser Permanente Northern California medical center, the Director Revenue Cycle is the can-do problem solver and leadership contact for all revenue cycle-related areas and issues, including: direct management of Admitting and Patient Financial Advisors; matrixed accountability of TPMG Medical Office Clerical Coordinate or support and participation in the medical center’s revenue oversight group (ROG);providing leadership, coordination and subject matter expertise across all components of the revenue cycle; monitoring revenue cycle performance metrics; enhancing the members’ experience within the Kaiser Permanente system by developing and implementing streamlined, customer-friendly revenue cycle processes; and driving revenue cycle awareness and education at the medical center.

Successful candidate will exude nuanced assertiveness, organizational diplomacy, and an inherent desire to build durable working relationships in matrixed organization. Reporting to Kaiser Foundation Hospitals (KFH) and The Permanente Medical Group (TPMG), the Director Revenue Cycle acts as a liaison and a thought partner to the two entities, maintains a strong link to regional Revenue Cycle leaders and initiatives, and ensures the sustainability of all Medical Center based revenue cycle activities.

EDUCATION/LICENSE/CERTIFICATION:

Bachelors degree in business administration, economics, finance, accounting, or related field.

PREFERRED EDUCATION/LICENSE/CERTIFICATION:

Bachelors degree in Accounting, Business Administration, Finance, Health Administration or related field is required, or equivalent work experience, Master’s Degree such as MBA, MHA, MPH or PHA is preferred,  Other certifications in finance or healthcare is preferred, but not required, such as CPA

QUALIFICATIONS:

Substantial (8-10 years) directly related financial experience with analytically challenging projects. Significant (3+ years) general management experience. Knowledge in one or more of the following: accounting, finance, Quantitative analysis, financial analysis, healthcare economics, information systems, organizational development, health care delivery systems, project management or new business development. Knowledge of applicable federal and state laws and regulations related to the healthcare industry. Excellent communications, presentation and interpersonal skills.  Able to manage through influence and collaboration. Excellent skills in complex analytic problem solving, strategic planning, program development, project management, change management and group process. Demonstrated effectiveness in staff development, team building, conflict resolution and group interaction. Proficiency with Microsoft office (i.e., Excel, Word, PowerPoint). Direct operational experience. Significant experience with KP data sources.  

PREFERRED QUALIFICATIONS:

Ten years or more in a progressive revenue cycle role including experience with integrated health care delivery systems and multi-facility health systems (advanced education/training also considered).  Minimum of five years in a relevant management level position.  Minimum of five years experience specifically directing revenue cycle activities for hospital and/or large medical groups with a successful track record in process improvement, improved collections and meeting revenue cycle goals and benchmarks.  Excellent working knowledge of revenue cycle operations and insurance benefits and product development.  Demonstrated experience in strategic and business planning, strategic information systems, operations improvement and reengineering, project management, and business case development and financial analysis. 

TECHNICAL KNOWLEDGE & SKILLS:

Directed activities that lead to measurable and sustainable improvements in any of the following areas:  Bad Debt Reduction, Business Office Operations, Charge Description Master, Charge Capture, Denials Management, Clinical Documentation, Health Information Management/Coding, or Patient Registration. Ability to lead and achieve success in a consensus based environment. Design and re-designed revenue cycle systems: consulted with appropriate stakeholders to identify issues related to revenue cycle and worked within the operations units to develop and then manage action plan.

Demonstrated ability to utilize effective financial management tools, information systems methodologies and supervisory techniques. Developed and maintained budget and operating plan for revenue cycle operations. Ability to analyze trends, develop and maintain performance goals and regularly provide information to senior management. Skilled in coaching, counseling and developing others to achieve operational objectives including teaching the fundamentals of revenue cycle operations and objectives.

Skilled in team building, team participation, and achieving organizational success. Excellent written, oral and interpersonal (negotiation and listening) communication skills are required for interacting with all levels of health care professionals within the Hospital and Medical Group. Demonstrated experience working collaboratively with providers and executives, both inside and outside an organization. Advanced proficiency in all Microsoft computer applications (i.e. Excel, Powerpoint and Access) and other job-related networks and software. 

DUTIES:

Serves as an expert consultant to executive leadership on major and highly complex healthcare issues with strategic importance. Provides leadership and direction for the department in accordance with the overall strategic direction of Finance. Communicates information strategically, delivering results-oriented messages. Actively monitors operational and financial performance to anticipate and meet the needs of leadership. Drives for changes in work products and processes that will improve departmental efficiencies and effectiveness. Applies thorough understanding of key business processes to effectively anticipate and address the longer-term implications of decisions/actions. Manages all steps of major projects or processes and adjusts planned approach as required. Fosters a positive and proactive work environment, emphasizing respect for individuals, high standards of quality, customer service, innovation and team work. Fosters strong results orientation within department by motivating staff and holding them accountable to meeting customer needs and organizational goals. Facilitates the ongoing learning, well-being, professional satisfaction and development of staff through training, work assignments, increased responsibility/autonomy and mentoring. Facilitates the ongoing learning, well-being, professional satisfaction and development of staff through training, work assignments, increased  responsibility/autonomy and mentoring. Partners with local and regional leadership to find new ways to enhance financial products and services. Understands interrelationships among systems and process across functional areas to redesign process, improve efficiency, and ensure optimal results. Identifies and communicates opportunities for change to improve performance.

OTHER DUTIES:

Strategic Planning, Influence and Alignment:

Provides strategic counsel related to revenue cycle operations for a cross-functional, multi-disciplinary leadership team. Supports medical center leadership in the development of tactical plans, operating budgets and resource allocation to achieve Revenue Cycle strategic goals. 

Collaborates with the Area Financial Officer, the Medical Office Controller, Regional Revenue Cycle, colleagues and subordinates in revenue cycle improvement initiatives. Partners with local and regional leadership to establish strategic, integrated operational business plans that support a sustainable and world class revenue cycle. Develops and strengthens relationships with local management in order to improve the level and quality of revenue cycle decisions that have financial, legal, and regulatory implications to the organization.

Collaborates with the clinic and facility directors and physician leaders of operating units to ensure that operations and processes remain consistent and emulate best practices. Supports the organization in the development of uniform Revenue Cycle policies and procedures. Develops local strategic planning processes in support of new initiatives and technologies to enhance the performance of the revenue cycle. 

Works closely with the Area Financial Officer, the Medical Office Controller and Regional Revenue Cycle to continue the evolution of revenue cycle operations and activities in Northern California, shifting strategies and tactics as necessary

Management and Team Building:

Plans, organizes, and directs through management and supervisory personnel the cost effective operations of various revenue cycle departments within the local service area. Hires, coaches, develops, disciplines and terminates staff as necessary.  Develops subordinates and establishes a climate for personal growth and development Works with direct reports to develop tactical and strategic solutions to meet the goals of this position. Helps to foster an environment and culture within the Revenue Cycle that is built upon open communication, trust and honesty, and collegiality.

Leadership and Consultative Experience:

Provide leadership in the development of reports, forecasts and budgets for non-dues revenue (revenue associated with visits or admissions versus revenue associated with payment of premiums) and other defined areas of responsibility. Provides education and direction as a servant leader creating opportunities for success for direct reports and medical center constituents. Formulates and makes recommendations to leadership on polices and practices relating to revenue cycle improvements.

Identifies opportunities for process improvement, and implements them by engaging stakeholders throughout the medical center. Monitors and assists with the development of action plans to proactively position the medical center or service area to effectively incorporate changes in legislation and accreditation standards that impact the revenue cycle. 

Assists with the development of business cases, in conjunction with other relevant subject matter experts, to support local or regional revenue cycle strategies.

Leads Labor/Management partnership initiatives.

Coordination and Project Management:

Leads the coordination of medical center implementation of key revenue cycle initiatives, including those related to compliance, KP HealthConnect updates and new releases, new products introduction, patient access, and point of service cost share collection. Represents and acts on behalf of the local and regional leadership in numerous special projects and committees involving key regional, facility and divisional managers. Coordinates and implements regional initiatives at the local level, including identifying and assembling resources when necessary.

Analyzes issues to develop recommendations related to course of action and resource requirements in order to achieve desired outcomes.  Delegate authority to Admitting managers for management of day to day operations and the completion of special projects.

Oversee work efforts as appropriate to ensure the highest quality and best possible delivery of services. Adhere to quality standards by setting and measuring performance outcomes.

Works with training and communications teams to ensure that appropriate local infrastructure is in place and that key information is getting to impacted staff and stakeholders in support of Revenue Cycle strategic initiatives.

Metrics and Reporting:

Drives operational improvements through monitoring, reporting and responding to local revenue cycle metrics.

Compliance, Quality Assurance and Quality Control:

Facilitates compliance with administrative/legal requirements and governmental regulations as it relates to revenue cycle operations. Monitors departmental compliance with internal controls (Sarbanes Oxley) and develop remediation plans to address identified control weaknesses. Supports Kaiser Permanente Northern California and Revenue Cycle policies and procedures. Accountable for revenue cycle data quality monitoring and related training.

Ensures all practices relating to the acquisition and maintenance of information comply with federal, state and hospital regulations, policies, and procedures.