VP Revenue Cycle Management - Johns Hopkins Health System

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POSITION SUMMARY

This Vice President of Revenue Cycle Management is responsible for providing leadership for all activities related to the revenue cycle operations management of the Johns Hopkins Health System and the Johns Hopkins School of Medicine. This position is responsible for Financial Clearance, Health Information Management, Patient Financial Services, and Revenue Cycle Director Liaisons at each of the hospitals and a dotted line relationship with the International Revenue Cycle. This position is responsible for achieving five fundamental objectives:

• Meeting the organization's annual cash targets
• Appraising, forecasting and determining a desired set of future conditions and strategies to achieve goals and objectives of the enterprise.
• Overall strategy, alignment, execution and delivery of revenue cycle services and programs.
• Managing the receivables in a prudent manner so as to optimize its net realizable value
• Providing world-class service to JHHS and SOM customers that continually exceeds their expectations

The incumbent serves as the spokesperson for the enterprise internal and external organizations, including governmental agencies, payer organizations, external auditors, other healthcare providers, etc. The incumbent is expected to provide strategic vision to the department, challenging assumptions and standards of business, in an effort to improve overall operational effectiveness.

REPORTING RELATIONSHIPS

Reports to the JHHS Executive Vice President of Finance and CFO/JHM Senior Vice President and Chief Financial Officer with additional dotted line reporting relationship to Vice Dean Finance and Administration at the Johns Hopkins University School of Medicine..

Directs activities of approximately 800 team members in the Registration, Central Financial Clearance, Health Information Management and Business Office through staff of Senior Directors, Directors, managers and supervisors

EDUCATION & EXPERIENCE

• A Bachelor's Degree in Accounting, Business Administration, Finance, or a related field; a Master's Degree in Business Administration, or a related field is required.

• A minimum of ten (10) plus years in leadership management that includes progressive financial management experience and expertise in revenue cycle operations and optimization with a complex healthcare environment.
• Prior work experience in a significant redesign project and/or management experience working in a highly automated, centralized or shared services office environment.
• Experience in using team building and quality management concepts to positively influence the work environment.
• Certification in CPAM or CHFP certification is strongly desired.

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES

• Organizational development, revenue, accounting, financial clearance, health information and receivable management principles.
• Hospital operations and patient flow to identify "cause-and-effect" scenarios that impact the effectiveness of the revenue cycle management process.
• In-depth understanding of financial clearance, health information management, third party billing and collection processes for hospital and professional fee billing, with particular focus on billing requirements, contractual arrangements, utilization review guidelines and certification/authorization processes.
• Accounting principles that directly impact the accounts receivable, including debit and credit transactions; charge transfers; contractual allowances and adjustments; financial class changes and revenue reclassification; and reserve methodology and mechanics.
• Coding principles that directly impact the coding accuracy of claims, including coding software, the query process, and clinical documentation.
• Healthcare accounts receivable management concepts, including an in-depth knowledge of reimbursement and the regulatory environment so as to ensure compliance with State regulations regarding patient and insurance billing issues.
• Understanding of Federal compliance and OIG initiatives that impact the healthcare industry.
• Technology alternatives applicable to the financial clearance, health information management and patient accounting environment - i.e., optical imaging, call center processing, collector workstation, 3M 360, HDM, HIPAA transactions sets, etc.
• Generalized understanding of networking infrastructure issues that impact the organization so as to better understand issues regarding connectivity and system performance.
• Coding, clinical documentation requirements and medical terminology.
• Standard PC word processing, spreadsheet and database applications.
• TQM and LEAN principles and techniques.
• Possesses leadership and mentoring skills necessary to provide support to both centralized departmental operations and decentralized affiliate operations and to promote employee development.
• Strong communication skills and the ability to be persuasive as well as collaborative.
• Excellent interpersonal skills in dealing with subordinates, co-workers, hospital staff, patients, payer representatives, administration and Board members.
• Proven analytical ability and organizational skills necessary to organize/assess information and evaluate recommendations based on data analysis.
• Excellent verbal and written communication skills to support interaction and participation in meetings with organizational leadership, patients, physicians, payer representatives, MHA, and representatives of other departments within the organization at large.

RESPONSIBILITIES

1. Setting and executing revenue cycle strategy, ensuring that operations are effectively integrated and aligned to support Johns Hopkins Medicine's overarching strategy
2. Providing operational direction and oversight for all hospital and professional revenue cycle operations leaders, including but not limited to:

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  • Patient Access-Pre-Registration, Registration, Scheduling, Financial Counseling and Clearance, Admitting
  • Hospital and Professional Billing and Account Resolution (guarantor and third-party payer collections)
  • Denials Prevention and Management
  • Transaction (cash and adjustment) posting and timely and compliant Credit Balance resolution
  • Customer Service / Call Center
  • Bad debt and financial assistance / coverage identification and enrollment
  • Revenue Cycle vendor selection and performance management
  • Optimization of Revenue Cycle technology enablers and workflow integration
  • Revenue Cycle performance (internal and external audits, quality reviews, qualitative and quantitative performance indicators and metrics, and training)
  • Provider Enrollment/Credentialing
  • Other as defined by Johns Hopkins Medicine
  
  
  
  

1. Providing operational guidance, partnership and leadership for all hospital and professional revenue cycle adjacent activities, including but not limited to:

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  • Revenue Integrity-Charge Description Master and Charge Capture and Revenue Reconciliation and Optimization
  • Health Information Management, Coding (inpatient, outpatient, professional / ambulatory), and Clinical Documentation Integrity
  • Payer Relationship and Reimbursement Management (input into contracting, monitoring and communicating payer policy changes and updates, and administration of payer performance scorecards that monitor, report, and trend individual payer payment lags, underpayments, denials, and other defined payer performance indicators)
  
  
  
  

1. Leading the design and execution of a standardized approach in revenue cycle people, process, and technology throughout Johns Hopkins Medicine
2. Leading the development, monitoring, and trending/reporting of Key Performance Metrics which will guide management decisions for achieving the goals of the revenue cycle and the overall financial performance of the enterprise
3. Leading the development and oversight of the annual operating and capital budgets for the Revenue Cycle Division
4. Ensuring the achievement of defined Revenue Cycle Division key performance metrics and revenue/expense targets
5. Developing and maintaining effective relationships with executive and physician leadership across the Johns Hopkins Medicine enterprise
6. Establishing and advancing collaborative working relationships with key external organizations including other providers, payers, government entities, and applicable professional associations
7. Negotiating and establishing shared services agreements and frameworks to support the organization's goals
8. Ensuring that appropriate controls exist throughout the enterprise to create accountability and effective management of the enterprise revenue cycle
9. Remaining current and ensuring compliance with regulatory, third-party payer, and contractual changes impacting revenue cycle operations
10. Participating in and/or chairing various committees (ex: Governance Counsel) to provide leadership and lend revenue cycle expertise.
11. Developing and deploying best-in-class, results oriented Revenue Cycle organizational structure and team that ensures consistent high performance and achievement of goals
12. Facilitating the communication, coordination, and implementation of enterprise business process and/or technology strategic initiatives involving revenue cycle

PROBLEM SOLVING

1. Evaluates, monitors and assists in developing the priorities and progress of JHHS revenue cycle functions.
2. Provides senior management with information regarding revenue cycle, receivable and/or departmental performance.
3. Through management staff, implements improvements in work process that both improve the efficiency and effectiveness of the revenue cycle management process.
4. Works closely with senior management to evaluate new affiliate candidates vis-a-vis consolidation opportunities. If an affiliate's revenue cycle l services are to be consolidated, leads the consolidation planning and implementation efforts.
5. Leads redesign initiatives and other JHM or Health System-sponsored initiatives, as required based on the organization need and regulatory environment.
6. Works with management staff on systems and payer issues that impact the ability to achieve JHHS targets and goals.
7. Identifies opportunities for improved efficiency through better processes and additional automation. Monitors impact of process-oriented changes on staffing requirements.
8. Serves as an organizational sponsor for implementation of any software applications that improve the overall functionality of the revenue cycle management group. This may include installation of new HIM coding, bill editing software, a real-time eligibility querying module, an automated secondary billing application, automated payment and rejection posting routines, or enhancements to the core legacy applications that improve billing and collections effectiveness.
9. Focus on integrated revenue cycle operations across all system entities increasing communication and streamlining support system, process and resources to create a well-coordinated service experience for patients, physicians, and internal stakeholders.
10. Oversees the management of continuous improvement of operations standards maximizing efficiency and positively impacting key revenue cycle metrics and performance indicators.
11. Leverages LEAN methodologies to both lead and support breakthrough improvement projects to reduce denials, eliminate waste and improve service experience.

BUDGET RESPONSIBILITY:

1. Administers expense budget for a large department.
2. Presents departmental budget recommendations to JHHS Executive Vice President of Finance and CFO/JHM Senior Vice President and Chief Financial Officer for approval.
3. Monitors budget performance and provides variance explanations.
4. Authorizes non-capital purchases in accordance with policies

Salary Range: Minimum $0.00/hour - Maximum $0.00/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility.

In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

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