Director - Physician Revenue Cycle (1.0 FTE, Days)
1.0 FTE, 8 Hour Day Shift
At Stanford Children’s Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continuing education and state-of-the-art facilities, like the newly remodeled Lucile Packard Children's Hospital Stanford. And it's why we need caring, committed people on our team - like you. Join us on our mission to heal humanity, one child and family at a time.
This paragraph summarizes the general nature, level and purpose of the job.
The Director of Physician Revenue Cycle Management is responsible for promoting the financial viability of the Stanford Children’s Health by effectively managing the organization's physician revenue cycle operations including the physician billing for the enterprise. The Director works in close partnership with many aspects of the organization and is central to creating a comprehensive and seamless physician revenue cycle throughout Stanford Children’s Health. In addition, the Director plays a key role in strategies for payer contracting, evaluating service and geographic expansions and evaluating and onboarding new practice acquisitions. The Director will lead the coordination with the Physician Revenue Cycle (FPO) and PCHA Operations teams to streamline physician revenue cycle processes and improve efficiency of the staff, systems and processes. The Director will manage the physician revenue cycle analytics team which will provide physician revenue reporting across the enterprise including internal reporting used to manage revenue performance. The Director will serve as a key member to the Ambulatory Strategy and Planning team in evaluating and analyzing revenue opportunities as part of the larger strategic growth, partnership and competitive initiatives led by the Strategy and Business Development team.
The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.
Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings.
Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital(s).
- Works closely with the Chief Revenue Officer on long-term strategies to improve yield, reduce cost to collect, improve operational efficiencies and execute on organizational goals
- Develops and implements policies and procedures related to physician billing processes including FPO charge entry and coding, payer contract performance, claim billing, AR resolution and training and compliance in these areas
- Coordinates with leadership in Finance (CFO, Finance Manager, Accountants) to determine financial reserve models and monitor performance
- Develops short-term and long-term department budget and monitors and manages budget variances
- Establishes performance goals and expectations relevant to the physician revenue cycle and physician billing. Prepares annual objectives, plan of action and budgets, as appropriate. Monitors benchmark data related to revenue cycle performance
- Coordinates with the CSO, CMO, VP of Ambulatory and other key physician leadership to evaluate and strategic, partnership and market competitive initiatives. The primary focus of this function is to proactively evaluate revenue opportunities and impacts of changes to physician practice operations and lead the physician revenue cycle execution of these initiatives
- Coordinates with the PCHA CEO, COO, Director of Physician Recruitment and other support staff to evaluate and onboard community-based physician practices in support of organizational growth strategies
- Participates in the FPO leadership committees (Finance, Management, Operations, Physician Relations) to represent and address revenue cycle, gather support for process improvements and report on financial performance.
- Supports FPO and PCHA Executive Leadership in budgeting, financial projections, developing policies and procedures, designing revenue cycle best practices and producing revenue reporting for Foundation Board Meetings
- Facilitates positive communication and build strong relationships between Physician Revenue Cycle Management Operations and PCHA Executive leadership (CEO, COO, Chief Medical Officer, Director of Operations, Director of Physician Recruitment, Director of Compliance), practice management and staff, other physician revenue cycle staff and payers regarding revenue cycle matters
- Develops the framework for modeling the Funds Flow calculations with the Senior Director of Physician Network Finance including the School of Medicine Departmental reporting
- Defines and manage physician revenue cycle reporting to meet the needs and expectations of all constituencies (Executive Financial Leadership; Physician Leadership; Director, Finance & Administration -DFAs; Director of School Medicine Finance Support) and ensures timely reporting of physician revenue cycle performance through collaboration with appropriate information sources
- Manages numerous vendor and IT relationships related to the physician revenue cycle
- Ensures compliance with federal and state laws specifically pertaining to the physician revenue cycle by analyzing internal policies and implementing appropriate changes
- Monitors and researches regulatory changes affecting physician revenue cycle and proposes actions to respond to changing legislation/regulation to revenue
- Monitors physician revenue cycle performance reports to ensure compliance with targeted goals and objectives
- Leads the continued optimization of Epic Physician Revenue Cycle system design, processes and training support targeted to efficiently maximize revenue yield, proactively identify revenue cycle errors prior to billing and building a system for providing feedback across the 100+ impacted practices and departments.
- Participates in various IT-related steering committees for information technology changes which affect the revenue cycle and leads planning initiatives for revenue cycle IT related enhancements
- Participates in Manage Care Contracting Strategic Committee as a member, with active involvement in pricing and contracting strategy decisions. Ensures that payer contract performance is monitored. This may require representing all physician-related (FPO and PCHA) considerations with the VP and Director of Managed Care to address specific geographic payer needs
- Identifies opportunities for improvement and initiates action to elevate and sustain outcomes
- Participates in other special projects or short-term initiatives impacting physician revenue cycle (i.e. ICD-10, Meaningful Use, HI-TECH, and others)
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: Bachelor's degree in a work-related discipline/field from an accredited college or university
Experience: Seven (7) years of progressively responsible and directly related work experience
Knowledge, Skills, and Abilities
These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.
- Ability to develop long-range business plans and strategies
- Ability to foster effective working relationships and build consensus
- Ability to mediate and resolve complex problems and issues
- Ability to organize, prioritize, multi-task, and adapt to changing priorities
- Ability to present and discuss financial data in a manner that is understandable and actionable
- Ability to provide leadership and influence others
- Ability to recognize and analyze the impact of regulatory changes on the financial performance of physician revenue
- Knowledge of Coding Standards
- Knowledge of computer systems and software used in functional area
- Knowledge of government program regulations and requirements as they related to accounting and billing
- Knowledge of local, state and federal regulatory requirement related to the functional area
- Knowledge of principles and practices of financial management
- Knowledge of principles and practices of organization, administration, fiscal and personnel management
Physical Requirements and Working Conditions
The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.
Equal Opportunity Employer
Lucile Packard Children’s Hospital Stanford strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, LPCH does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements, and where applicable, in compliance with the San Francisco Fair Chance Ordinance.