Manager, Medical Group, Revenue Cycle Operations
Company: Trinity Health
Location: Fresno
Posted on: August 3, 2022
Job Description:
Employment Type:Full timeShift:Description:Responsible for
implementation of current and future best practices for revenue
cycle functions. Responsible for charge capture, over sees and
directs the charge capture team locally. Accountable for key
revenue cycle outcome.POSITION PURPOSEProvides support and
day-to-day operational management for the Medical Group and
Provider Services (MGPS) Revenue Cycle operations; including
registration, insurance verification, POS collections,
authorizations, charge capture and charge controls, revenue
integrity and optimization, coding and general practice revenue
cycle operations. May have oversight for payer enrollment and
credentialing and other practice related functions. Manages the
strategic focus of operational excellence through central oversight
and management of revenue cycle practices across the region to
ensure standardization, implementation and utilization of top
decile practices. Serves as a key change leader. Works closely and
collaborates with Regional CFOs, Patient Business Service (PBS)
center, C-Suite, Payer Strategies, MGPS Practice Leaders, Hospital
Site Operations leaders and other leaders and colleagues across the
organization. Incumbent reports to Regional Director or Director of
MGPS Site Operations or will have an A2 relationship to both the
Vice President of MGPS RC Site Operations and the Regional or Local
Finance leader. ESSENTIAL FUNCTIONSKnows, understands,
incorporates, and demonstrates the Trinity Health Mission, Vision,
and Values in behaviors, practices, and decisionsManages Medical
Group revenue cycle operations for the region, including proper
implementation of system and local goals to ensure standard and top
decile operations.Manages the implementation of current and future
best practices for revenue cycle functions to allow all practices
to be efficient and market relevant, including overseeing the
implementation and monitoring of adherence to payer contracts and
procedures. Provides effective use of system resources to drive
optimal revenue cycle outcomes.Responsible for establishing
partnerships with senior leadership at the RHMs, MGPS Finance
leaders, Payer Strategies and PBS Leaders to gain feedback,
develop, and implement action plans to improve front-end Revenue
Cycle processes that have a direct impact on billing and
collections for account resolution.Manages the selection,
direction, and development of new team members to ensure effective
growth and utilization of talent. Conducts performance appraisals
for team leadership and oversees the cascading goals for the teams.
Creates a culture that is supportive of personnel, fostering
individual motivation, teamwork and high level of performance and
accountability utilizing a participative management style to ensure
colleague retention.Manages in the selection and facilitation of
appropriate process and technology training of colleagues to
achieve technical proficiency, efficiency, regulatory compliance,
and customer service in Revenue Cycle areas.Manages regional
budgets and targets allowing for financial oversight of the
regional Revenue Cycle department functions.Collaborates with MGPS
senior leadership and Finance leaders, Practice leaders, PBS
leaders, regional directors, regional clinical leadership, and
colleagues to accomplish key performance goals, implement
performance improvement via A-3 projects and other strategic
initiatives, and identify opportunities for improvement through the
integration of people, process, and technology.Collaborates with
Hospital Site Operations, Vice President of MGPS RC Site Operations
and the Regional or Local Finance Leader to direct and lead local
Revenue Cycle and oversee the professional Revenue Integrity
functions, including but not limited to: Charge Description Master
(CDM), Pre-bill edits assigned to Revenue Integrity, complex
coordination and denial prevention.Accountable for key revenue
cycle outcomes based on RHM performance, in collaboration with
local site leadership, PBS leadership, and System Office
leadership, including but not limited to:
- Financial secure rate (Insurance Verification)
- Authorization rate
- Upfront collections
- Denial rate
- Colleague quality and productivity
- Colleague Engagement and Satisfaction related to Revenue
Cycle
- Patient Engagement and Satisfaction
- FY Budget TargetsMaintains a working knowledge of applicable
Federal, State and local laws/regulations; the Trinity Health
Integrity and Compliance Program and Code of Conduct; as well as
other policies and procedures to ensure adherence in a manner that
reflects honest, ethical and professional behavior.MINIMUM
QUALIFICATIONS Must possess a comprehensive knowledge of physician
practice revenue cycle operations, revenue metrics and analytics,
and revenue management, as normally obtained through a Bachelor's
degree in business or Healthcare administration or a related field,
and five (5) to seven (7) years of revenue cycle operations,
revenue metrics and analytics, and revenue management experience or
an equivalent combination of education and experience.Minimum of
three (3) years of management experience in a multi-facility,
integrated health care delivery system or revenue cycle or
consulting experience.Knowledge of revenue cycle and accounting
systems and insurance issues, healthcare industry issues and
trends, legal issues in field of expertise, required third party
and governmental guidelines, and work processing. Epic experience
strongly preferred.Exhibits strong leadership, integration and
execution skills with considerable experience in planning,
formulating, and execution strategies with the ability to define
program, process, or business objectives and scope, while also
demonstrating proficiency and expertise to identify, evaluate and
articulate operational opportunities, and risks, business
needs/gaps, and understand customer/stakeholder
interests.Demonstrates advanced analytical, evaluative, problem
solving and decision-making skills to serve in managerial role in
inspiring and initiating new ideas, determining strategies in the
absence of guidelines, fostering innovative approaches to
situations/processes/issues and executing multiple critical
assignments.Possess excellent written and verbal communication
skills to effectively identify, assess and facilitate improvements
and resolution to present advisory, persuasive and authoritative
recommendation to all levels.Proficiency in Microsoft Office,
including Outlook, Word, PowerPoint, and Excel.Maintains
professional development and growth through journals, professional
affiliations, seminars, and workshops to keep abreast of trends in
revenue cycle operations and healthcare in general:
- Participates as appropriate in continuing educational programs
and activities that pertain to healthcare and revenue cycle
management, as well as specific functional areas;
- Develops and implements an annual plan of personal and
professional development;
- Participates in local, regional and national health care
revenue activities and professionally represents Trinity Health at
these functions.Serves in a leadership role and promotes positive
Human Resource Management skills:
- Fosters teamwork atmosphere between business and clinical
stakeholders;
- Retains, recruits and manages staff to achieve strategic
objectives; and
- Provides staff training and mentoring.Must demonstrate strong
organizational skills leading a combination of direct and
dotted-line reporting relationships. Exhibits strong, collaborative
leadership qualities that can bridge across multiple
disciplines.Must be able to travel approximately 25% of the time as
may be needed in the region. This may include travel to MGPS
locations outside of the Region and to System Office as may be
necessary.Must be comfortable operating in a collaborative, shared
leadership environment.Must possess a personal presence that is
characterized by a sense of honesty, integrity and caring with the
ability to inspire and motivate others to promote the philosophy,
mission, vision, goals and values of Trinity Health.LEADERSHIP
COMPETENCIES As a Trinity Health Executive, the incumbent is
expected to demonstrate leadership traits, which support our
Mission Statement and Core Values as identified below: Mission
Statement: We, Trinity Health, serve together in the spirit of the
Gospel as a compassionate and transforming healing presence within
our communities.Core Values:
- Reverence: We honor the sacredness and dignity of every person.
- Commitment to Those who are Poor: We stand with and serve those
who are poor, especially those most vulnerable.
- Justice: We foster right relationships to promote the common
good, including sustainability of Earth.
- Stewardship: We honor our heritage and hold ourselves
accountable for the human, financial and natural resources
entrusted to our care.
- Integrity: We are faithful to those we say we are.PHYSICAL AND
MENTAL REQUIREMENTS AND WORKING CONDITIONSThis position operates in
a typical office environment. The area is well lit, temperature
controlled and free from hazards.Incumbent communicates frequently,
in person and over the phone, with people in all locations on
product support issues.Manual dexterity is needed to operate a
keyboard. Hearing is needed for extensive telephone and in person
communication.The environment in which the incumbent will work
requires the ability to concentrate, meet deadlines, work on
several projects at the same time and adapt to interruptions.Must
be able to set and organize own work priorities and adapt to them
as they change frequently. Must be able to work concurrently on a
variety of tasks/projects in an environment that may be stressful
with individuals having diverse personalities and work
styles.Ability to thrive in a fast-paced, multi-customer
environment, with conflicting needs which some may find stressful.
May warrant varied and/or extended hours, with changes in workload
and priorities to keep pace with the industry and advance strategic
priorities.Must be able to travel approximately 25% of the time as
may be needed in the region. This may include travel to MGPS
locations outside of the Region and to System Office as may be
necessary.Must possess the ability to comply with Trinity Health
policies and procedures.The above statements are intended to
describe the general nature and level of work being performed by
persons assigned to this classification. They are not to be
construed as an exhaustive list of duties so assignedOur Commitment
to Diversity and InclusionTrinity Health is a family of 115,000
colleagues and nearly 26,000 physicians and clinicians across 25
states. Because we serve diverse populations, our colleagues are
trained to recognize the cultural beliefs, values, traditions,
language preferences, and health practices of the communities that
we serve and to apply that knowledge to produce positive health
outcomes. We also recognize that each of us has a different way of
thinking and perceiving our world and that these differences often
lead to innovative solutions.Our dedication to diversity includes a
unified workforce (through training and education, recruitment,
retention, and development), commitment and accountability,
communication, community partnerships, and supplier diversity.
Keywords: Trinity Health, Fresno , Manager, Medical Group, Revenue Cycle Operations, Executive , Fresno, California
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