Job Description
| Job Summary: Key Job Responsibilities |
| The Executive Director of Payer Revenue Management will direct strategy, decision support, organizational planning and operational leadership to maintain/enhance a high functioning and effective revenue cycle. This position will drive professional and/or hospital revenue cycle transformation through teamwork, metric management, technology, and standardization. Oversight includes insurance billing and follow up, denials, appeals, underpayments, and cash management functions to ensure maximized revenue and cash flow. |
| Responsible for the successful daily operations of professional and/or hospital revenue cycle functions measured by revenue maximization through best practice KPI’s such as A/R days, charge lags, net collection rate, primary denial % and first pass resolution rates while ensuring delivery of quality customer service to health system stakeholders | |
| Evaluates effectiveness of all aspects of the revenue cycle that impact the billing and collection work functions, and creates more effective and efficient workflow processes. | |
| Supports the Vice President, Payor Revenue Management in strategic planning, innovation, goal setting and other areas that may arise relating to professional and/or hospital accounts receivable. | |
| Develops performance goals and determine plans, priorities, and work assignments to achieve them | |
| Leads innovation and operational enhancements/standardization by leveraging best practices and technology to create a best-in-class accounts receivable and billing operations | |
| Works alongside the CSRC Management team to set long and short range goals, and implements strategies to meet desired objectives. | |
| Proactively collaborates with key stakeholders and operational teams to maximize revenue cycle efficiencies and improve collections | |
| Responsible for proactive engagement of payors, staff and vendors to ensure healthy revenue cycle KPI’s | |
| Proactively manages overall budget, including personnel, capital and other equipment, supplies, etc. Includes budgetary control as an expectation of the Managers | |
| Reviews and evaluates on a regular basis, the effectiveness of third-party billing, tracing and follow-up activities; oversees development and maintenance of good working relationship with third parties and government agencies receiving claims from CSMC. | |
| Manages executive relationship with key health system stakeholders (department chairs and administrative leadership) through monthly revenue cycle meetings to discuss performance, issue identification and solutions to issues impacting revenue and cash flow |
| Responsible for hiring, onboarding, managing schedules, personnel actions, performance reviews, and performance improvement plans. |
| Plans, leads, and directs work of staff to ensure goals and objectives are completed within established budget and deadlines are met. |
These statements describe the primary duties and responsibilities of the job and are not intended to be an exhaustive list of all tasks. Other work duties may be assigned at any time with or without notice. |
Qualifications
| JOB QUALIFICATIONS |
| Education | |||
|---|---|---|---|
| Education Level | Education Details | Minimum | Preferred |
| Bachelor's Degree | Health Care Administration or related field | X | |
| Master's Degree | Health Care Administration or related field | X | |
| Work Experience | |||
|---|---|---|---|
| Years of Experience | Experience Details | Minimum | Preferred |
| 7 years | Managerial in billing and collections in a hospital or very large, multi specialty medical group | X | |
| 5 years | Strong financial and analytical skills, understanding of complex revenue cycle, insurance billing and collection departments and familiarity with CPT-4 and ICD-10 coding. | X | |
| Skills, Knowledge and Abilities | ||
|---|---|---|
| Skill/Knowledge/Ability | Description | Proficiency |
| Analytical - Ability to demonstrate problem solving skills and recommends solutions | Demonstrated success working independently, forging relationships, and managing multiple tasks with minimal directions. | Advanced |
| Budgetary & Financial - Ability to apply knowledge of business, revenue and profitability model(s) | Ability to analyze qualitative and quantitative information for decision support. | Advanced |
| Communication - Ability to convey and/or receive written/verbal information to/from various audiences in different formats | Demonstrated ability to interact with clients and colleagues in a thoughtful and attentive manner | Advanced |
| Communication - Ability to communicate expectations and priorities, and clarify roles and responsibilities | Strong interpersonal and communication skills. And has full command (verbal and written) of the English language. | Advanced |
| Management - Ability to foster individual/team development, performance feedback, coaching and recognition | Ability to work in teams, ability to work independently, ability to follow directions, ability to manage completion of multiple tasks within specified timeframes. | Advanced |
| Quality - Ability to provide and/or support a level of work excellence and accuracy; recognize and address flaws or errors that others may overlook | Ability to analyze qualitative and quantitative information for decision support. | Advanced |
| Regulatory - Ability to interpret and apply knowledge of State, Federal and Agency standards to comply with regulations | Maintains strict patient confidentiality according to HIPAA regulations and applicable law. | Advanced |
| Technical - Ability to use software applications and operate technological devices (e.g., computer, laptop, tablet, smartphone, etc.) | Demonstrate standard computer skills, use of electronic health record, and office skills as relevant to duties. Must possess a minimum computer competency comprised of a working knowledge of Windows or comparable system (specifically including keyboard and mouse skills). As applicable to individual job duties and expectations, employee must additionally possess a working knowledge of word processing, spreadsheet, presentation development, e-mail, browser and online reporting. Demonstrate standard computer skills, use of electronic health record, and office skills as relevant to duties. Must possess a minimum computer competency comprised of a working knowledge of Windows or comparable system (specifically including keyboard and mouse skills). As applicable to individual job duties and expectations, employee must additionally possess a working knowledge of word processing, spreadsheet, presentation development, e-mail, browser and online reporting. | Advanced |
| Time Management - Ability to handle multiple demands and/or manage complex and competing priorities | Working knowledge of subject matter domain areas in clinical quality, patient safety, regulatory and reimbursement context. Ability to deliver safe, appropriate, ethical and evidence-based care in an effective, efficient and professional manner; incorporates feedback, self-reflection, sound clinical reasoning and problem solving to continuously improve quality of care and operational processes. | Advanced |
| Licenses and Certifications | ||||
|---|---|---|---|---|
| Licenses/Certifications | Lic/Certification Details | Time Frame | Minimum | Preferred |
| No license or certification required | ||||
| Department Specific Licenses and Certifications | |||||
|---|---|---|---|---|---|
| Additional licenses or certifications that are required/preferred in the specific department(s) below: | |||||
| Department | Licenses/Certifications | Lic/Certification Details | Time Frame | Minimum | Preferred |
| PHYSICAL DEMANDS/WORKING CONDITIONS | |
| Working Environment Catagory | Office Environment |
| Physical and Other Demands | ||||||
|---|---|---|---|---|---|---|
| A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act and California Fair Employment and Housing Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job, with or without reasonable accommodation. | ||||||
| Physical Demand | N/A | Rarely | Occasionally | Frequently | Constantly | Weight |
| Stand dynamically to perform a function and move to perform another. | X | |||||
| Stand statically in one place to perform a function without changing location. | X | |||||
| Sit at a desk or table with some walking, standing, bending, stooping, or carrying of light objects. | X | |||||
| Perform continuous operation of a personal computer for four hours or more. | X | |||||
| Use hands and fingers to handle and manipulate objects and/or operate equipment. | X | |||||
| Climb stairs and/or ladders. | X | |||||
| Bend, crouch, stoop, stretch, or crawl. | X | |||||
| Bend upper torso and reach up and out with hands and arms. | X | |||||
| Balance the body while walking, standing, crouching, or stooping to prevent falling. | X | |||||
| Perform unaided lifting of objects, please list the amount of weight that would be lifted, along with the frequency required. | X | Up to 20 lbs. | ||||
| The physical demands described here are representative of those that must be met by an employee to successfully perform the primary duties and responsibilities of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions |
| Working Environment | |||
|---|---|---|---|
| While performing the duties of this job, the associate is required to meet the following physical demands: | |||
| Working Condition | N/A | Yes | No |
| Extreme cold | X | ||
| Extreme heat | X | ||
Humid | X | ||
| Wet | X | ||
| Noise | X | ||
| Hazards | X | ||
| Temperature Change | X | ||
| Atmospheric Conditions | X | ||
Vibration | X | ||
| Other | X | ||
| Travel Requirements | |
|---|---|
| Est. Amount | Brief Description |
| 0% | |
| Valid Driver's License Required | |
|---|---|
| Yes/No | Reason for Drivers License |
| No | |
| The work environment characteristics described here are representative of those an employee encounters while performing the primary duties and responsibilities of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. |
About Us
About the Team
Req ID : 1820
Working Title : Exec Dir, Payer Revenue Management
Department : CSRC HB AR Follow Up
Business Entity : Cedars-Sinai Medical Center
Job Category : Patient Financial Services
Job Specialty : Revenue Integrity
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $70.79 - $127.42
Our compensation philosophy
We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above takes into account the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role. Pay Transparency Non Discrimination Provision (PDF) (opens in new window)
Diversity and Inclusion at Cedars-Sinai
We are caretakers and innovators committed to the pursuit of equitable healthcare. But health equity is not possible without representation. Our commitment to diversity goes beyond demographics or checking boxes. Our people must reflect the diverse identities, experiences and geographies of the communities and patients we serve – because that’s what our patients, colleagues and communities deserve. Quality Care and Research—For All, By All (opens in new window).
Cedars-Sinai is an Equal Employment Opportunity employer.
Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.
Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.
At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu) and COVID-19. For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines such as COVID-19 as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy. Cedars-Sinai’s AA Policy Statement (PDF) (opens in new window)
