Director Revenue Cycle Automation, Strategic Planning

2 weeks ago

Hamtramck, Michigan, United States Henry Ford Health System Full time

The Director Revenue Cycle Automation, Strategic Planning & Coding Operations directs and oversees clinical revenue cycle automation, Emergency Department, and Inpatient Professional Coding operations. Job duties include oversight of automation planning, implementation, and optimization of the revenue cycle and clinical operations.

This position leads through sharing knowledge, motivation and empowerment of the internal and external customers to provide high quality services, which meet or exceed expectations. Through collaboration with members of the teams, identifies departmental and business unit priorities, establishes goals, and implements strategies designed to foster a culture of innovation, employee engagement, customer satisfaction, and exceptional business performance.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Daily Operations

  • Continuously surveils industry technology for applicability to all areas of clinical revenue cycle. Partners with leaders from other business units to understand and mitigate barriers.
  • Responsible for leadership within clinical teams to promote documentation standardization for the health system.
  • Responsible for all hospital coding functions to include Inpatient professional and Emergency Medicine coding and charge entry, edit resolution, and coder education.
  • Designs, implements, and maintains coding outcome indicator scorecards, metrics, benchmarking, and other related business intelligence in hospital coding performance.
  • Responsible for coordination of information governance within the EHR including compliance, HIM director, Physicians, applicable committees, and others.
  • Directs and coordinates interactions with Service Line leaders to maximize the use of the support services and coding functions to meet the needs of the clinical departments, identifying training and system gaps and developing strategies to address these gaps.
  • Provides oversight and analysis of employee/operational performance; recommends changes and enhanced efficiencies.
  • Provides periodic monitoring and analysis of productivity metrics to ensure service standards are being met and individual workflows are appropriate.
  • Works with Revenue Cycle management team to ensure effective, efficient coding processes for overall improved financial performance.
  • Manages MS DRG/ICD-9/ICD-10/CPT code usage to ensure accurate, effective communication with physicians regarding coding trends and accurate coding to maximize reimbursement.
  • Collaborates with HFHS departments to ensure services performed are charged and posted in a timely and compliant manner.
  • Maintains revenue cycle accountability to the business units.
  • Prepares annual budget and manages expenses and staffing levels.
  • Partners with key leaders across the system to enhance the hospital coding processes.
  • Recruits and develops leaders, to build a culture for high performance and engaged workforce.
  • Responsible for the continued integration and management of consistent processes, policies, and technology.
  • Oversees/directs the development of policies and procedures for the department.
  • Participates in data collection for performance measures, investigates opportunities and implements solutions for optimization.
  • Demonstrates belief in the mission of Henry Ford Health System through the ability to articulate, interpret, and incorporate its mission into departmental goals and objectives.
  • Supports the standards set forth in the HFHS Code of Conducts by creating an atmosphere of commitment to legal and ethical standards.
  • Establishes priorities and long and short-term strategic goals of the department with the assistance of the management team. Ensures staff is aligned with the goals and objectives related to Revenue Cycle for the organization.
  • Actively participates in various committees such as Revenue Cycle Coding Council, Compliance.
  • May develop and/or lead committees/teams related to coding, regulatory changes, performance improvement and compliance.
  • Ensures that information systems support current and future needs of the department. Works closely with information technology in transition planning including, but not limited to, testing, installation and education of staff to produce and maintain high quality data integrity.
  • Creates and manages strategic partnerships with on shore and off-shore vendors and third-party systems to ensure optimization of costs and quality.
  • Monitors performance of external vendors with monthly performance metrics and standards compared to benchmarks.
  • Performs other related duties as assigned.
Compliance
  • Responsible for maintaining regulatory compliance with external agencies and state and federal regulations for Medical record and coding related standards for each business unit and the health system. Ensures staff is kept informed and educated on process and regulatory changes.
  • Assures support services function meets all current regulatory compliance and HIPAA transaction requirements and keeps current with MS-DRG and ICD-9/ICD- 10/CPT coding rules and regulations.
  • Works with risk management, legal counsel, and administrative staff, key departments, providers, and committees to ensure that the organization maintains appropriate compliance including privacy and security and confidentiality policies, procedures, forms, coding, and materials that reflect current organizational practices and regulatory requirements.
Quality Management
  • Is the guiding force behind the identification, establishment and maintenance of quality improvement activities related to medical record and hospital coding services. Promotes the principles of quality improvement and utilizes the results of quality improvement activities to identify areas where change would benefit the team and its customers.
  • Working with appropriate System and Revenue Cycle leadership, ensures HIM and Hospital Coding representation and participation in appropriate external collaboration, think tanks, benchmarking groups, best practices, other initiatives at the local, state, and national levels.
EDUCATION/EXPERIENCE REQUIRED:
  • Bachelor's degree in Health Information Management, Accounting, Business Administration, Finance, or other business related field.
  • Master's degree in a business or a health administration related field, preferred.
  • Five years management experience required with director level, preferred.
  • Knowledge of best practices related to revenue cycle operations.
  • Experience at a large, complex, integrated healthcare organization, preferred.
  • Communication skills and the ability to interact effectively with staff.
  • Ability to manage, coordinates, and lead simultaneously. Ability to estimate time frames and meet projected deadlines.
  • Ability to work with a variety of individuals in executive, managerial and staff level positions.
  • Ability to work independently.
  • Ability to understand and lead change.
  • Goal- oriented, exceptional interpersonal skills, change management and political skill.
  • Demonstrate experience in all areas of medical record functions, including privacy & compliance regulations.
CERTIFICATIONS/LICENSURES PREFERRED:
  • CPC, CCS, CCS-P, RHIT, or RHIA, preferred

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