Region Director Revenue Cycle Compliance - California

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Job description

Overview:
Dignity Health one of the nation's largest health care systems is a 22-state network of more than 9000 physicians 63000 employees and 400 care centers including hospitals urgent and occupational care imaging and surgery centers home health and primary care clinics. Headquartered in San Francisco Dignity Health is dedicated to providing compassionate high-quality and affordable patient-centered care with special attention to the poor and underserved. For more information please visit our website at (url removed). You can also follow us on Twitter and Facebook.

Responsibilities:
This position is responsible for managing projects and support initiatives of the Optum Service Level Agreement including: Dignity Compliance Office, Optum, Transformation Plan Owner, and Optum SLA/Performance Metrics Owner. In addition the director works with hospital leadership from 29 facilities in California to manage the relationship between Optum and individual facilities The position also addressed revenue cycle compliance and performance concerns specific to the California region.

Conduct in depth review of High Dollar encounters for the facilities to identify patterns that can be addressed in real time to avoid errors which will lead to denials

Establishing clear key performance indicators (KPIs) to measure the effectiveness of revenue cycle operations.

Developing and maintaining comprehensive compliance programs to ensure adherence to federal, state, and local regulations. Partnering with our compliance team to review RAC/MAC cases, mitigate risks and avoid penalties

Set system wide priorities and work with peers to identify leading practice solutions that mitigate financial, operational or personnel-related risks/barriers

Qualifications:
Required:

Minimum of five (5) years of progressive experience in managing healthcare business functions and minimum of five (5) years of revenue integrity or revenue cycle experience

Bachelor's degree in business, health or public administration, management, or a related field required

Preferred:

Master's degree in hospital or business administration, accounting, finance or a related field preferred

Special Skills:

Ability to influence key stakeholders at various organizational levels

Strong leadership skills and commitment to a team approach; both direct and indirect reports

Competency in developing efficient and effective solutions to complex business challenges

Familiarity with management reporting, metrics and goal setting

Excellent knowledge of revenue cycle and other healthcare financial performance metrics

Deep familiarity with revenue cycle policies and procedures

Extensive knowledge of current healthcare trends, policies, and regulations

Understanding of coding classifications systems such as, but not limited to, ICD- 10-CM, ICD-9-CM, MS DRG, APR DRGs, and HCCs strongly preferred.

Comprehensive understanding of computer, database, and network technologies

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