AVP Clinical Revenue Cycle

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MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor’s Degree in nursing, health administration, business, or related field

EXPERIENCE:

1. 5 years of management experience in healthcare revenue cycle

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Master’s Degree or Professional Certification

2. Licensed physician (MD or DO)

EXPERIENCE:

1. Experience performing assessments and clinical integration projects in healthcare revenue cycles

2. Experience as Physician Advisor or similar

3. Prior experience with Epic

4. Experience working in an organization of size and complexity comparable to WVU Medicine.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Works with WVU Medicine physician leadership and finance executives to develop strategies for revenue cycle support and/or optimization initiatives. 

2. Oversees coordination of physician advisory program in support of revenue cycle functions; Ensures coordination and work functions and processes from the physician advisor group.

3. Develops project plans for identified and requested revenue cycle initiatives, including project teams, timelines, risks, and mitigation plans and engages stakeholders as appropriate through charter development, planning, implementation, and monitoring.

4. Ensures the quality and productivity of the clinical revenue cycle teams, developing a trusted team with accurate, dependable findings and high overturn success rates

5. Analyzes clinical revenue cycle KPIs to identify areas of improvement. Leads root cause and action planning for performance improvement initiatives. Monitor trends and communicate significant shifts in market or operating conditions to the Management Team. 

6. Advises physicians of clinical documentation best practices and establishes best in class education program for admission criteria, level of care determinations, severity of illness, medical necessity, and documentation integrity.

7. Provides support and advice on the technical and operational design of and impacts to clinical revenue cycle workflows and advises on innovative practices in clinical revenue cycle, such as artificial intelligence

8. Directs the day-to-day operations of clinical revenue cycle operations; Creates and executes the vision of a high-performing and well-respected clinical revenue cycle

9. Maintain an integrated WVU Medicine revenue cycle. Partner with clinical operations departments on revenue cycle components of ordering practices and denial prevention.

10. Optimizes capabilities in EPIC and all other related information systems, tools, technologies, and processes. Oversees all system changes and development to ensure accurate and complete system functionality.

11. Maintains high quality, accuracy, and compliance of DRG coding, query prevention and effectiveness, documentation scores, and appeal overturn success.

12. Oversees implementation of training education programs for CDI and medical staff and assures training programs are implemented to recruit and manage for future growth.

13. Simplifies the communication and engagement of revenue cycle clinical teams, across a complex organization.

14. Advises finance executives, physician leadership, and Epic IT team of system implications of operational decisions.

15. Directs programs or compliance components of larger cross-functional programs by identifying and managing stakeholder contacts; assembling teams based on program needs and team member strengths; developing, analyzing, and managing program plans; negotiating and managing program schedules and resource forecasts; and managing program financials and deliverables.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Ability to sit for extended periods of time.

2. Ability to lift, push or pull 10–15 pounds.

3. Visual acuity must be within normal range.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Office type environment

SKILLS AND ABILITIES:

1. Organizational and professional skills; ability to lead large teams

2. Oral and written communication; ability to effectively represent the department across all levels of the organization including executive leadership

3. Ability to establish new partnerships and influence the work of others

4. Knowledge of local, State and Federal regulations pertaining to payer policy and clinical documentation.

5. Ability to independently manage large-scale, multi-functional projects

6. Advanced Knowledge of office software applications and Epic modules

Additional Job Description:

Scheduled Weekly Hours:

Shift:

Exempt/Non-Exempt:

Company:

Cost Center: