Director Mid Revenue Cycle

Advocate Aurora Health; Milwaukee (WI); On-site; USD 120,000 - 180,000; Full time

Job summary

Advocate Health is seeking a seasoned MRC Director in Milwaukee to lead the Mid Revenue Cycle with strategic, operational and financial oversight. You will align function priorities with enterprise goals, optimize processes, ensure regulatory compliance, and drive performance via KPIs across coding, denial management, and analytics.

You will build a high-performing team, collaborate across clinical, IT and finance units, and implement standardized workflows to improve efficiency, accuracy and

Qualifications

• Minimum 10 years in mid-revenue cycle, coding, HIM, or healthcare technology.
• 2+ years of leadership experience in a large integrated healthcare system.
• Relevant industry certification from an approved accrediting body.
• Bachelor's degree in Health Information Management, Healthcare Administration, or related field, or equivalent experience.

Responsibilities

• Strategic Leadership: define function priorities, KPIs, and align with division goals.
• Operational Leadership: lead Mid Revenue Cycle sub-functions to meet governance and regulatory standards.
• Operational Efficiency: evaluate processes to improve efficiency and standardize best practices.
• Regulatory Compliance & Confidentiality: ensure compliance with regulatory standards and protect patient information.
• Coding Denials and CS Requests: direct resolution of coding denials and disputes to ensure timely reimbursement.
• Performance Monitoring & Reporting: develop and monitor KPIs and quality metrics to drive improvement.
• Quality Assurance: maintain high quality, implement corrective actions as needed.
• Technology Utilization: leverage EHR and analytics tools to enhance efficiency.
• Collaboration & Stakeholder Engagement: liaise across units to drive value and alignment.
• Team Leadership & Development: hire, coach, and develop staff for performance and growth.
• Strategic Initiatives & Execution: contribute to strategic initiatives within Mid Revenue Cycle.

Skills

Strategic Leadership

Operational Leadership

Operational Efficiency

Regulatory Compliance

Coding Denials

Performance Monitoring

Quality Assurance

Technology Utilization

Collaboration & Stakeholder Engagement

Team Leadership

Strategic Initiatives

Education

Bachelor's degree in Health Information Management or Healthcare Administration

Tools

EHR systems

Microsoft 365

Job description

Major Responsibilities:

• Strategic Leadership: The MRC Director recognizes the division's mission and strategic priorities and identifies the role of the function and sub-functions under his/her leadership to serve the MRC division. The MRC director assumes responsibility for defining their function/sub-function strategic priorities, core operations, and KPIs to contribute to the MRC division success.
• Operational Leadership: Lead assigned Mid Revenue Cycle sub-function area(s) to ensuring alignment with divisional and enterprise-wide goals. service delivery meets organizational goals and regulatory requirements.
• Operational Efficiency: Evaluate processes to improve efficiency, enhance productivity, and support standardized best practices across the Mid-Revenue Cycle.
• Regulatory Compliance & Confidentiality: Ensure adherence to regulatory requirements, accreditation standards, and organizational policies. Maintain confidentiality of patient records and report any perceived non-compliant practices to leadership or the Compliance Department. Align coding practices with regulatory requirements and implement strategic plans to enhance coding quality and audit processes.
• Coding Denials and Customer Service Requests: Direct resolution of professional and hospital coding denials to ensure accurate and timely reimbursement. Oversee the timely resolution of Customer Service department requests related to HIM Coding disputes.
• Performance Monitoring & Reporting: Develop, implement, and monitor quality standards, workflows, and productivity metrics to optimize team performance. Utilize key performance indicators (KPIs) to measure effectiveness, track trends, and implement data-driven strategies for improvement.
• Quality Assurance: Maintain a high standard of quality and oversee processes and implement corrective actions as needed to ensure high reliability, accuracy and optimal reimbursement.
• Technology Utilization: Leverage healthcare technology and analytics tools to enhance efficiency, support decision-making, and drive innovation in Mid-Revenue Cycle processes.
• Collaboration & Stakeholder Engagement: Serve as a liaison across Mid-Revenue Cycle and other organizational units to ensure processes drive value, support enterprise-wide initiatives and priorities and adhere to regulatory requirements. Build and maintain relationships with key stakeholders to drive communication, problem-solving, and operational alignment.
• Team Leadership & Development: Manage and develop a team of professionals by performing human resource functions such as hiring, performance evaluations, and professional development. Provide training, feedback, and career growth opportunities to foster a high-performing and financially responsible workforce. Ensure proper staffing, training, and resource allocation to meet operational demands and quality standards.
• Strategic Initiatives & Execution: Contribute to the development and execution of strategic initiatives within the Mid Revenue Cycle to support Advocate Health's long-term goals.

Licensure, Registration, and/or Certification Required:

• Relevant industry certification from an approved accrediting body.

Education Required:

• Based on function areas, may include Bachelor's degree in Health Information Management, Healthcare Administration, or a related field, or equivalent experience.

Experience Required:

• Minimum 10 years of experience in mid-revenue cycle operations, coding, HIM, or healthcare technology, including 2+ years of leadership experience in a large integrated healthcare system.

Knowledge, Skills & Abilities Required:

• Strategic Leadership: This requires strategic mindset, excellent skills in collaboration, communication, organization, prioritization, planning and implementation in order to successfully execute on their function/sub-function's role in supporting the division's mission, strategic priorities and KPIs/goals.
• Mid-Revenue Cycle Expertise: Recognize the function/subfunction role within the MRC division as relates to overall divisional success. Demonstrated knowledge of facility coding, professional coding, and HIM operational guidelines and workflows necessary to scope of work. Understanding of third-party reimbursement programs, state and federal regulatory requirements, national and local coverage decisions, and coding classification systems (ICD-10, CPT, HCPCS).
• Financial & Data Analysis: Ability to organize, compile and analyze data from various sources in order to detect patterns, and identify areas for improvement.
• Technology & Systems Proficiency: Strong understanding of EHR systems and other revenue cycle technology solutions. Proficient in Microsoft 365 products, including Teams, SharePoint, Word, Excel, PowerPoint, and Access.
• Process Improvement & Standardization: Experience in optimizing workflows and improving operational effectiveness within a complex healthcare environment. Skilled in prioritizing business needs and resource management to develop efficient and scalable processes.
• Leadership & Team Development: Proven ability to manage teams, coach staff, and foster a culture of continuous improvement and accountability. Ability to work effectively across multiple departments and within matrix organizational structures.
• Collaboration & Cross-Functional Communication: Strong interpersonal skills with the ability to engage clinicians, finance, IT, and revenue cycle teams to align goals, facilitate integration, and drive strategic initiatives.
• Problem-Solving & Attention to Detail: Ability to identify and solve problems creatively, work within deadlines, and maintain a high level of accuracy and attention to detail.

Physical Requirements and Working Conditions:

• Exposed to normal office environment.
• Job may require travel, therefore, may be exposed to road and weather hazards.
• Must be able to lift up to 40 lbs. occasionally.
• Sits the majority of the workday, but also may lift, reach, and bend throughout the day.
• Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.