Director - Revenue Cycle

The Director of Revenue Cycle provides leadership to the Revenue Cycle continuum – registration, coding, billing and medical record management. Also responsible for insurance contracting, compliance and privacy. 

Essential Duties and Responsibilities: 

1. Strategic Planning

• Monitors and identifies the evolving factors that affect current/future needs of functional service lines, and recommends strategies/initiatives/programs/projects to prepare for future growth of service lines and program areas in alignment with overall organizational strategy (provision of new services, standardization of policies/practices across the organization, increasing market share, maximizing revenues, cross-selling services, improving efficacy/cost-effectiveness of clinical services provided, enhancing patient outcomes/satisfaction and others of similar complexity and consequence).
• Develops formal strategic/tactical plans, to include both short- and long-term business planning, with full accountability for achievement of plan objectives.

2. Operational Accountability

• Plans, directs, and evaluates the programs, systems, operations, and resources of the department, to assure the safe and appropriate delivery of best-practice procedures and patient care, achievement of strategic objectives within scope of responsibility, and compliance with regulatory requirements.
• Develops and implements policies and procedures in accordance with industry standards; assesses and assures staff compliance and competence.
• Collaborates with other leadership to standardize and integrate practices; participates and contributes to organization-wide evaluation of effectiveness of implemented programs and procedures. 
• Evaluates effectiveness of patient care and promotes continuous quality improvement.
•  Manages registration, billing and collections, coding, revenue integrity, patient account services and medical records, to ensure accurate billing and timely collection of revenue for hospital and clinic services. 

3. Staff Management and Development

• Plans, directs, and evaluates work of direct reports and facilitates planning, direction, and evaluation of direct report subordinate staff.
• Ensures adequate staffing levels and coverage based on acuity and need with budgetary and operational objectives.
• Ensures staff are appropriate trained and competent in performance of assigned duties; assesses competencies of staff on regular basis.
• Coaches, mentors, and develops staff to promote skill development and leadership capacity.
• Serves as the primary interface on all revenue cycle related issues including department oversight, technical and governmental issues, billing and collection remediation. 

4. Performance and Quality Improvement

• Continuously monitors and assesses systems and programs to ensure compliance and achieve quality and performance objectives.
• Establishes appropriate performance measures for programs and staff; analyzes appropriate data to assess progress, and recommends/implements adjustments as appropriate to maintain progress towards established strategic objectives.
• Evaluates existing systems/program/priorities, analyzes future potential to make recommendations for growth, expansion, new services and solvency of existing services based on market demographics and volume projection; develops and presents comprehensive recommendations regarding the viability of specific systems/projects. 
• In coordination with Quality program stakeholders, plans and directs quality process improvement initiatives/projects to ensure achievement of business objectives.

5. Budget and Fiscal Administration

• Determines financial resources necessary to achieve establish strategic performance objectives; develops recommendations in accordance with internal policies and procedures.
• Identifies, aligns, and optimizes resources to maintain financial stability of programs and service lines.
• Exercise effective cost control measures, adjusts resources as needed to maintain budget.
• Identifies negative variances and develops and implements action plans/recommendations to address issues in a timely manner; keeps Executive leader apprised of all issues with potential for budgetary impact.
• Oversees the preparation of complete and accurate financial, budget, activity and productivity information, including variance reports, financial projections and other statistical reports for programs and service lines. 

6. Regulatory Compliance

• Ensures all functional areas are in full compliance with internal and external legal and regulatory standards; regularly assesses and monitors to ensure effective controls are in place and desired outcomes are achieved.
• Ensures compliance with all record management and retention policies, provisions, and practices.

Requirements

Education & Licensure: 

• Master's in business or related field preferred or
• Bachelor's in business or related field required

Experience:

• Minimum of 10 years' experience in related experience in a hospital or health care related environment
• Three years' experience in healthcare revenue cycle leadership role or demonstrated leadership capabilities

Knowledge, Skills & Abilities: 

• Strong, collaborative, and effective working relationships with providers, leadership, and staff
• Strong interest in clinical quality improvement and innovation
• Exhibit an independent drive, and have the ability to lead change
• Exhibit excellent communication and organizational skills

Supervisory Responsibilities:

• Revenue Cycle continuum – registration, coding, billing and medical record management

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer
• Prolonged periods of standing, bending, and reaching
• Must be able to lift up to 15 pounds at times

St. Health has been a healing force in the St. Croix Valley for over 103 years. We are a purpose-driven organization with a dedicated team committed to serving our patients and communities throughout the St. Croix Valley. This commitment is rooted in our mission, vision and values.

Mission:  We help people live healthier, happier, and longer lives.

Vision:  To transform from quality sick care to quality well care that is sustainable and affordable.

Values:  People Centered, Trust, Innovation, and Growth.

Here at St. Croix Health we offer our employees with a robust benefits package that includes:

• Health, vision and dental insurance
• 403b retirement program with employer match
• Paid time off
• Short-term disability, long-term disability and life insurance options
• Education reimbursement
• Employee assistance program (EAP)
• Wellbeing incentive program
• Free parking
• Employee prescription discount program

St. Croix Health is a not-for-profit healthcare system located in St. Croix Falls, WI dedicated to helping people live healthier, happier, and longer lives. St. Croix Health offers the services of 80+ providers and 20 specialties with five community clinics in Minnesota and Wisconsin all supported by a critical access hospital on the main campus in St. Croix Falls, just an hour northeast of Minneapolis/St. Paul. Nestled in the bluffs of the St. Croix River Valley, St. Croix Falls is the ideal place to work, live and play.