Revenue Cycle Management Director

4 days ago


Gisborne, Gisborne, New Zealand Tbwa ChiatDay Inc Full time

About the Role: We are seeking a seasoned Revenue Cycle Management Director to lead and oversee all aspects of Forge Health's revenue cycle management (RCM) and payer contracting functions. This role will drive achievement of RCM performance through continuous optimization of all revenue cycle operations and improvement of key processes.

Key Responsibilities:

  • Directly manage the Revenue Cycle operations team, ensuring operational execution on timely, high-quality billing submissions.
  • Drive continuous optimization of all revenue cycle operations by measuring, analyzing, and interpreting revenue cycle and reimbursement data.
  • Develop and implement revenue cycle management policies and procedures that maximize efficiency and optimize performance.
  • Provide senior leadership oversight of the revenue cycle operation, driving performance/operational planning and developing performance objectives for the director and their direct reports.

Payer Contracting:

  • Develop, recommend, and implement payer contracting strategy for fee-for-service and value-based initiatives with commercial health plans, Medicaid, and Medicare partners.
  • Assist in leading and driving negotiations with existing and new payer partners.
  • Serve as the subject matter expert related to payer-specific requirements, reimbursement logic, accreditation requirements, and other critical aspects of payer contracts.

Requirements:

  • At least ten years of experience in revenue cycle management in healthcare in positions of increasing responsibility.
  • Demonstrate comprehension of payer contracts, with special attention to complexities and details.
  • Problem-solving skills in order to identify problems, evaluate options, and execute solutions.
  • Relevant healthcare industry knowledge and market awareness.


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