Vice President of Revenue Cycle

Position Purpose

The Vice President of Revenue Cycle plays a pivotal leadership role in overseeing the design and optimization of healthcare provider-based revenue cycle processes, consulting, and project management. This position is responsible for reviewing and managing contracts, fostering effective contractor and vendor relationships, establishing service level agreements, and monitoring the delivery of services.

This leader has responsibility over patient access/registration, patient estimates, insurance verification, pre-authorization, financial counseling, coding, health information management, billing, follow up collections, cash posting, refunds, self-pay, customer service, bad debt, revenue cycle training, denial prevention, vendor management, compliance, financial reporting and policies and procedures as they relate to the capture and realization of revenue.

Nature and Scope

Utilizing strong financial management skills, the VP analyzes operational financial data, oversees budgeting, auditing, forecasting, accounting, accounts receivable and reserve analysis, market analysis, staffing, and financial reporting. The role requires exceptional leadership to motivate cross-departmental teams, drive performance through consensus-building management styles, and communicate complex financial concepts to diverse audiences. The VP demonstrates an ability to positively influence outcomes through persuasive engagement, problem-solving, and the administration of multifaceted revenue cycle processes, regardless of direct authority. Building committed teams and implementing process improvements based on key performance indicators are also vital, particularly in environments resistant to change. Maintaining high energy and creativity under pressure, prioritizing multiple objectives, and cultivating effective relationships across all organizational levels are integral to ensuring the successful achievement of quality outcomes in a dynamic healthcare landscape. This role is expected to provide:

• Strategic Leadership: Develop and implement a comprehensive revenue cycle strategy aligned with the health system’s mission, vision, and financial objectives. Lead cross-functional teams to drive best practices and foster a culture of accountability and performance excellence.
• Operational Oversight: Provide direct leadership over revenue cycle departments, including patient access/registration, insurance verification, pre-authorization, health information management (HIM), medical coding, charge capture, billing, accounts receivable, denials management, and collections. Assesses new technology, performs vendor assessments, creates ROI analyses, and recommends new solutions.
• Revenue Optimization: Analyze revenue cycle processes for opportunities to maximize reimbursement, reduce denials, shorten revenue cycle timeframes, improve cash flow, and reduce cost to collect. Initiate and monitor performance improvement initiatives. Investigates and resolves complex problems and coordinates efforts to provide innovative strategies and solutions.
• Compliance & Risk Management: Oversee compliance with all applicable laws, regulations, and standards (e.g., HIPAA, CMS, Joint Commission) governing the revenue cycle. Develop policies and procedures to mitigate risks and ensure data integrity, patient privacy, and audit readiness.
• Technology & Innovation: Evaluate and implement revenue cycle management technology solutions (such as EHR, billing and coding software, analytics tools, and Artificial Intelligence tools) to enhance efficiency, accuracy, and transparency. Stay abreast of industry trends and proactively position the health system as a leader in revenue cycle innovation.
• Financial Reporting & Analysis: Maintain strong understanding of revenue cycle metrics and leads team in building plans to support operational departments to achieve best practice performance through strong analytical capabilities, process improvement identification, and technology enhancements. Collaborate with Finance to monitor key performance indicators (KPIs), develop budgets, and forecast revenue. Report financial results and operational metrics to senior leadership.
• Patient Experience: Champion a compassionate, patient-centric approach to revenue cycle processes, ensuring clear communications, fair billing practices, and supportive financial counseling services.
• Talent Management: Recruit, develop, mentor, and retain a high-performing revenue cycle team as measured through the achievement of benchmark process outcomes, audit and compliance results. Provide ongoing training, performance feedback, and leadership development opportunities.
• Stakeholder Collaboration: Work closely with clinical operations, compliance, IT, and other departments to ensure smooth handoff points and integration of revenue cycle processes with overall health system operations. Build revenue cycle business literacy across the health system and develop collaborative relationships with key stakeholders across departments.
• Regulatory & Legislative Monitoring: Stay informed about changes in healthcare reimbursement, government regulations, and industry standards. Ensure organizational readiness and compliance with evolving requirements.

Disclaimer

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Minimum Qualifications

Requirements - Required and/or Preferred