Executive Director Revenue Cycle

Description Job Summary The Executive Director of Revenue Cycle leads the end-to-end revenue cycle across Nicklaus Children's Health System. Provides oversight of front-end, mid-cycle, and back-end revenue functions and is accountable for achieving performance targets. Partners closely with operational leaders, Managed Care, Finance, IT, and external vendors to drive sustainable financial performance, operational efficiency, and a high-quality patient experience aligned with the organization's mission to deliver exceptional pediatric care. Job Specific Duties * Lead and optimize all components of the revenue cycle, including: * Patient access (scheduling, registration, authorization, financial counseling) * Case Management, Social Work, Pastoral Services, and Transfer Center * Health information management (HIM), coding and CDI * Revenue integrity, Charge Description Master (CDM), charge capture, and billing * Patient financial services, A/R follow up, Appeals and Underpayments, Cash/Credit Management, and Customer Service * Ensure seamless coordination across all functions to achieve timely and accurate revenue capture and reimbursement. * Lead governance and performance management of the organization's outsourced revenue cycle vendor(s), inlcluding: * Establishing and enforcing SLAs tied to key KPIs (e.g., net collection rate, AR days, denial rate) * Conducting regular business and performance scorecard reviews * Driving continuous improvement and corrective action plans for underperformance * Partnering on optimization initiatives (automation, AI, workflow redesign) * Oversee contract performance, escalation management, and alignment of vendor operations with system goals. * Oversee key revenue cycle metrics, including, but not limited to: * Days in AR- * Denial rates- * Net collection rate, including complex large balance claims- * Bad debt performance- * Excess/Avoidable Days * Coding accuracy * Point of Service Collections * Call Center and Pre-Access Metrics: Speed to Answer, Accuracy, Authorization Days Out, etc. * Patient Financial Experience * Develop and maintain a structured performance reporting framework and accountability forums. * Analyze trends and implement targeted initiatives to improve financial outcomes. * Partner with leadership and vendor partners to define and execute a multi-year revenue cycle strategy: * Technology optimization (e.g., EMR revenue cycle platforms, automation, analytics tools) * Shared services and operating model design * Integration of vendor and internal workflows * Collaborate with IT teams and vendors to identify system enhancements and ensure alignment with business needs. * Ensure adherence to all regulatory, payer, and compliance requirements (IRS, OIG, CMS, HIPAA, payer contracts). * Mitigate financial risk through strong internal controls and processes. * Lead and develop a high-performing revenue cycle organization, including internal leaders and vendor teams. * Establish clear accountability structures, performance expectations, and training programs. * Foster a culture of continuous improvement, collaboration, and service excellence. * Demonstrate strong communication and collaboration skills across the enterprise. * Partner with clinical and operational leaders to enhance transparency and the overall patient financial experience. * Ensure patient-friendly billing practices and effective patient financial assistance programs. Qualifications Minimum Job Requirements * Bachelor's Degree in Business or Healthcare Administration * 7-10 years of progressive experience in the healthcare revenue cycle * Healthcare industry financial statistical indicators experience Knowledge, Skills, and Abilities * Master's degree preferred. * HFMA, AAHAM, or similar professional certification preferred. * Epic experience preferred. * Florida Medicaid experience preferred. * Proven ability to lead large-scale operational and transformation initiatives. * Deep understanding of end-to-end revenue cycle processes, including, billing, coding, reimbursement, and denial management. * Strong leadership and communication skills. * Experience in negotiating contracts and resolving vendor/service issues. * Demonstrated experience managing outsourced revenue cycle vendors or shared services models. * Knowledge of healthcare regulatory requirements and payer dynamics. Job: Management Department: NCHS-REVENUE CYCLE MANAGEMENT-1000-900905 Job Status: Professional