Director Mid Revenue Cycle

Carolinas Medical Center; Milwaukee (WI); Presencial; USD 87.000 - 131.000; Jornada completa

Descripción de la vacante

Carolinas Medical Center in Milwaukee seeks a seasoned leader for the Mid Revenue Cycle to direct Coding Production Operations: Administrative. This role oversees strategy, service delivery, compliance, and audit processes to optimize reimbursement and performance.

The Director will manage denials resolution, data-driven improvements, and cross-functional collaboration, while guiding a team through HR functions and professional development. M-F, 40 hours/week; benefits eligible; pay range posted.

Formación

• Bachelor's degree in Health Information Management, Healthcare Administration, or related field; may vary by function area.
• Minimum 10 years in mid-revenue cycle operations, coding, HIM, or healthcare tech.
• 2+ years of leadership experience in a large integrated healthcare system.

Responsabilidades

• Provide strategic leadership for the Mid-Revenue Cycle; define function priorities, core operations, and KPIs to support the MRC division.
• Lead assigned sub-function areas to ensure alignment with divisional and enterprise goals; ensure service delivery meets regulatory requirements.
• Evaluate processes to improve efficiency, productivity, and standardized best practices across the Mid-Revenue Cycle.
• Ensure regulatory compliance and confidentiality; align coding practices with requirements and enhance audit processes.
• Direct resolution of coding denials and customer service requests; oversee timely resolution of HIM coding disputes.
• Develop and monitor quality standards, workflows, and productivity metrics; use KPIs to drive improvements.
• Maintain high quality standards and oversee processes with corrective actions to ensure reliability and optimal reimbursement.
• Leverage healthcare technology and analytics to drive efficiency and decision-making.
• Collaborate across units to ensure processes drive value and support enterprise priorities; build stakeholder relationships.
• Manage and develop a team with HR functions, including hiring, performance reviews, and development.

Conocimientos

Strategic Leadership

Mid-Revenue Cycle Expertise

Financial & Data Analysis

Technology & Systems Proficiency

Educación

Bachelor's degree in Health Information Management or Healthcare Administration

Herramientas

Microsoft 365

Descripción del empleo

Department:

10351 Enterprise Revenue Cycle - Coding Production Operations: Administrative

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

M-F Normal Business Hours

Pay Range:

$63.45 - $95.20

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