Vice President - Mid-Revenue Cycle

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This is a Stanford Health Care job.

A Brief Overview
The Vice President of Mid-Revenue Cycle is responsible for providing strategic leadership and direction for the health system's mid-revenue cycle operations across the enterprise. This role involves overseeing strategic planning, leadership, and operations support for Health Information Management, Hospital and Professional Coding Services, Charge Capture procedures, Revenue Integrity and Clinical Documentation Integrity. Aligned with compliance and governing regulations, this position ensures most appropriate and optimal revenue, diagnosis, procedure and quality information capture across all clinical encounters. Identifies meaningful opportunities to improve accurate representation of clinical encounters documentation. Prevents recurrence of issues that can cause revenue delays and revenue leakage degradation and compliance risks.

The Vice President works closely with all Revenue Cycle and charge-generating departments, School of Medicine leadership, Clinical Operations leadership, Managed Care Contracting, Quality, Controller's Office, Technology and Digital Solutions, Finance, Office of General Counsel and Compliance. They are accountable for effectively establishing health system policies within their scope, organizing efficient workflow, demonstrating leadership skills to attract, motivate, develop, evaluate and train skilled personnel, and employing strong interpersonal and collaboration skills to engage with all levels of the organization, affiliates and the School of Medicine and drive key outcomes for mid revenue cycle.

Locations
Stanford Health Care

What you will do

• Develops and executes a vision and strategy for mid-revenue cycle operations, ensuring alignment with overall organizational goals.

• Drive accountability by managing and measuring performance and progress on a regular basis to ensure team is achieving results.

• Plans, organizes, and directs the development and implementation of new policies, new roles for staff, new workflows and processes that assures that every process that affects revenue capture and clinical documentation is effective in optimizing all Technical (hospital) and Professional revenue and quality measures outcomes. Acts a liaison with each Director of Finance and Administration (DFA), Clinical Chief, Division Chief presenting on the total professional revenue picture and its management for their respective clinical areas.

• Collaborates with clinical leadership and key stakeholders to promote importance of accurate documentation in patient care, financial performance and quality reporting.

• Plans, organizes and develops an unified, multidisciplinary, outcome-focused clinical documentation integrity program in executing tactics for analyzing outcomes, prioritizing improvement efforts, and communication of expected practices and processes.

• Builds and support effective relationship with internal and external stakeholders and organizations. Develops partnerships, coordinates activities, review work, exchanges information, and/or resolves problems related to revenue integrity/revenue cycle programs and continuous improvement initiatives.

• Directs and participates in the development, implementation, and consistent application of effective organizational policies, procedures, and practices. Develops and support internal controls to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective an efficient, and compliance with current laws and regulations is achieved.

• Participates as a subject-matter expert and may lead or facilitate task forces, teams, and/or councils to plan, implement and coordinate programs, services, and/or activities for the organization.

• Identifies metrics and performance goals for revenue capture, hospital and professional coding and CDI. Metrics are set for each level of staff and team performance.

• Works collaboratively with Revenue Cycle leadership to define and implement tactical efforts in order to achieve Revenue Cycle's Strategic goals.

• Works closely with the Revenue Cycle Director of Reporting and Analytics to design reports that are relevant to the Clinical Chairs, Chiefs and DFA’s for each Clinical area. Communicates information strategically, delivering results-oriented messages.

• Meets monthly with School of Medicine Director of Finance and Administration to assure that all aspect of revenue capture is well managed in order to achieve the optimization of revenue.

• Meets regularly with peers in Ambulatory Care, Cancer Center and other revenue producing departments to assure appropriate synchronization between clinical activity, revenue capture and clinical documentation.

• Ensures compliance with federal and state laws pertaining to the revenue capture and reimbursement.

• Directs and coordinates communication with Technology and Digital Solutions to ensure appropriate systems, enhancements, and tools are utilized to effectively manage day to day Revenue Integrity operations.

• Evaluates purchases, contracts and services provided by external vendors to ensure best pricing and effective results (external vendors, reference tools, software tools, etc.), including ongoing vendor performance monitoring and issue resolution.

• Prepares organizational leadership to recognize and mitigate risks brought on by organizational changes.

Education Qualifications

• Master’s Degree in a work-related field/discipline from an accredited college or university.

Experience Qualifications

• Fifteen (15) years of progressively healthcare revenue cycle management.

• Ten (10) years leading middle/upper-level management.

• Recent EPIC system sue/experience including financial (billing – Hospital/Professional) and clinical documentation (EHR) functionalities.

• Five (5) years Coding/Nomenclature experience.

Preferred Knowledge, Skills and Abilities

• Proven capability in strategic thinking, sound judgement, and effective planning skills.

• Outstanding relationship management skills – easily builds strong and effective working relationships within a climate of trust, inspires cooperation and confidence and is a true consensus builder.

• Exceptional communication skills – ability to explain, advocate, and express facts and ideas in a persuasive manner, and effectively negotiate with individuals and groups internally and externally.

• Capacity to thrive in a complex environment such as the School of Medicine, managing multiple projects and deadlines, establishing priorities, setting objectives, and achieving stated goals; a demonstrated history of successfully implementing process improvements and driving high-performance outcomes while developing team members.

• Displays skills in organizational savvy by adapting own approach to the audience, anticipating impact of words and actions, preparing for possible resistance, and responding in an appropriate style, using a range of influencing styles.

• Proactive in leveraging opportunities to cultivate strategic relationships to accomplish specific goals.

• Skilled at identifying and engaging key influencers as change agents, involving them in the design and execution of change initiatives.

• High emotional intelligence and tactfulness in all situations.

• In-depth understanding of mid revenue cycle best practices, industry trends and relevant technologies/applications for both hospital and professional revenue cycle.

• Strong executive presence and communication skills that encourage appreciation for diverse perspectives while providing compelling insights and recommendations.

• Proven management abilities and a demonstrated track record of leadership.

• Comprehensive knowledge of healthcare financial trends and financial systems/tools.

• Commitment to providing guidance to assist direct reports in achieving growth, established goals, and desired outcomes.

• Skilled in leading change management to implement new and “best practice” approaches to business processes to improve customer service, operational effectiveness and financial results.

• Exhibits strength of character to champion risk-taking, a self-starter and self-motivated.

• A true collaborator, that can influence by actively listening and bringing multi-disciplinary teams (clinical operations, care providers, administration, etc.) together.

• Strong written and verbal communication skills, capable of delivering persuasive presentations to key internal and external stakeholders including senior leadership, peers and board members. Effectively communicates and listen effectively at all levels of the healthcare organization.

• Detailed knowledge of various payment and coding systems, particularly the Outpatient Prospective Payment System (OPPS), DRG's, MediCal/Medicaid APG Grouper, HCPCS and CPT-4 coding schemas.

• Knowledge of Medicare, Medicaid and other third-party billing coverage and compliance issues.

• Knowledge of CMS and State coding standards and charge capture (technical and professional) guidelines.

• Knowledge of Medicare documentation sources and regulatory guidelines.

• Understands financial management and health care reporting, including the relationship between the CDM, charging, coding and billing.

• Ability to develop long-range business plans and strategy.

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family’s perspective:

• Know Me: Anticipate my needs and status to deliver effective care

• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health

• Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) 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, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, 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.

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.