As a Vice President of Revenue Cycle & Managed Care, you will:
• Develop and implement strategies to optimize the end-to-end revenue cycle for ambulatory services.
• Oversee billing, coding, collections, and reimbursement processes to ensure accuracy and efficiency
• Monitor key performance indicators (KPIs) and implement improvements to enhance financial performance
• Collaborate with clinical and administrative staff to streamline workflows and reduce denials and write-offs
• Lead and mentor a team of revenue cycle and managed care professionals.
• Foster a culture of continuous improvement, accountability, and collaboration.
• Provide regular training and development opportunities for team members.
• Ensure compliance with all federal, state, and local regulations related to revenue cycle and managed care.
• Develop and implement policies and procedures to mitigate risk and ensure ethical billing practices.
• Prepare and present regular reports on revenue cycle performance.
• Conduct financial analysis to identify trends, opportunities, and areas for improvement.
• Develop and manage the department budget, ensuring alignment with organizational
• Lead the development and execution of the health system’s managed care strategy across all payer segments, including commercial, Medicare Advantage, Medicaid managed care, and self-insured employers.
• Direct the negotiation of all facility, professional, and ancillary contracts with commercial and government payers, ensuring competitive rates and operationally executable terms.
• Develop and maintain robust contract financial models to evaluate the revenue impact of proposed rate structures, reimbursement methodologies, and risk-sharing arrangements.
• Leverage revenue cycle performance data — including denial rates, underpayments, and claims adjudication patterns — to directly inform and strengthen contract negotiation positions.
• Maintain a comprehensive payer contract calendar and ensure timely renewals, amendments, renegotiations, and termination notices across all payer agreements.
• Serve as the senior executive liaison with payer network directors, medical directors, and government program administrators.
• Monitor market benchmarking data, competitor rate intelligence, and payer financial performance to sharpen negotiation strategy and identify new contracting opportunities.
• Stay current with industry trends, regulations, and best practices.