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.

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