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    Vice President, Revenue Management - Miami, United States - ChenMed

    ChenMed
    ChenMed Miami, United States

    3 weeks ago

    Default job background
    Full time
    Description

    We're unique. You should be, too.

    We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

    We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.

    The Vice President, Revenue Management is responsible for optimizing revenue from our payor (health plan) partners through contracting and contract management as well as end to end revenue cycle management. As a delegated full-risk company, ensuring we obtain all potential premium dollars from our payor partners is essential.

    ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

    • Central to this role is the responsibility for systemic approaches that contribute to the capture, management, and collection of patient service revenue. Contributing to the scalable growth of the overall business, and devises and manages the financial strategy and administrative processes, the leader primarily:
    • Negotiate percentage of premium contracts with multiple payors across multiple states.
    • Manage service fund model to ensure payors are fully transparent with medical costs and retain dollars only for coverage of medical costs and benefits.
    • Ensure all patient membership and revenue is attributed to enterprise.
    • Manage end to end process from Risk Adjustment to claim submission.
    • Will be accountable stakeholder for the platform development to manage the process.
    • Develop strategic direction and assist in road mapping tools across Finance. Implement systematic approaches to maximizing revenue and cash flow.
    • Oversee processes and systems used to set charges, negotiate with third-party payers, bill patients and insurers, file Medicare cost reports and claims, and pursue denied claims and delinquent accounts.
    • Direct the revenue cycle department in various duties, such as account management, communications with insurance providers, collections, cash posting, contract analysis and billing.
    • Provide feedback on the ideation, design, and launch of an innovative set of products supporting financial analysis.
    • Develop scalable processes/tools to support growth including developing plans for the enterprise.
    • Conduct sophisticated and creative analysis of complex data and translates the results into actionable deliverables, messages and presentations to support new products/services.
    • Capture data to support calculation and analysis, develops conclusions based on the prepared data, presents findings and complete document for executive review.
    • Through market research and understanding of evolving business needs and market trends, identifies and documents opportunities for new tools and services that support optimizing revenue. Identifies systems and process gaps to increase transparency, speed and automation to improve the financial planning process.
    • Collaborate with the executive team, analytics, finance and other departments to develop, refine and support the technology and strategy on a continual basis.
    • Engage with leaders of each functional area to understand what success looks like, identifies key performance indicators (KPI's) and builds effective reporting capabilities to measure progress and attain KPI's.
    • Ensure continual improvement of revenue management, through investment in people/process/ technology.
    • Lead and direct the work of other employees and has responsibility for all personnel actions.
    • Lead staff performance by providing regular feedback, performance reviews, and one-on-one meetings, regularly partnering with talent COEs for growth.

    KNOWLEDGE, SKILLS AND ABILITIES:

    • Advanced level business acuity
    • Expert knowledge and understanding of general/core job-related functions, practices, processes, procedures, techniques and methods
    • Strong analytical, accounting, statistical, mathematical, problem solving and quantitative skills with data-driven approach to enable decision-making; demonstrated innovative approach to problem resolution
    • Excellent communication and people skills to include ability to negotiate and resolve conflicts/build teams
    • Exceptional leadership and influencing skills cross functionally with stakeholders
    • Excellent relationships with clinical and business leadership, primary care physicians, center-based care teams, corporate teams, and other staff
    • Ability to effectively articulates and presents data, information and ideas in a clear and concise manner to high-level management and executives
    • Ability to ideate a strategic vision and successfully implement actions
    • Able to motivate staff; promote team building; assume leadership role within clinical arena
    • Sensitivity to needs of culturally and linguistically diverse patient and employee population
    • Advanced skill in Microsoft Office Suite products including Excel, Word, PowerPoint and Outlook; competent in other systems required for the position
    • Ability and willingness to travel locally, regionally and/or nationally up to 25% of the time; flexible to work evening, weekends and/or holidays as needed
    • Spoken and written fluency in English; bilingual a plus
    • This job requires use and exercise of independent judgment

    EDUCATION AND EXPERIENCE CRITERIA:

    • Master's degree in Business, Healthcare Administration, Finance or a related field required OR additional experience above the minimum may be considered in lieu of the required education on a year-for-year basis
    • A minimum of 10 years' experience in progressively responsible administrative or management-related positions required; preferably within a payor or risk-based primary health care environment
    • A minimum of 5 years of experience in leadership management experience required
    • Experience in Hierarchical Condition Category methodologies and encounter submissions required
    • Risk-Based Service fund payment experience required
    • Prior experience collaborating with interdisciplinary teams in quality improvement and/or medical/healthcare leadership activities preferred

    We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.

    ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.

    Current Employee apply HERE

    Current Contingent Worker please see job aid HERE to apply

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