Director Process Improvement System

POSITION SUMMARY:

Reporting directly to the Executive Director, Revenue Cycle Transformation, the Director, Process Improvement - System is responsible for providing the enterprise revenue cycle reporting, process improvement and analytical support at the BMC and BUMG system, including the Community Hospitals. This will encompass but not limited to the implementation/management of all reporting/process improvement initiatives, AI development, and analytic tools to support data analysis, and operational excellence.

The Director, Process Improvement - System must possess a thorough understanding of revenue cycle operations along with reporting expertise in Epics Slicer Dicer, and Cubes reporting technology, and will provide leadership and mentoring of managers/leads and other revenue cycle staff. The Director, Process Improvement - System will oversee the design, implementation, and operation of all enterprise revenue cycle reporting, analytic, and process improvement initiatives including AI. The Director, Process Improvement - System will also provide oversight to a team of managers and analysts to ensure that revenue cycle reliable metrics, reporting, analytics, and process improvement implementations are provided to BMC & BUMG system customers in a timely manner ensuring relevant information is encompassed to aid with decision-making and process change analysis.

Position: Director Process Improvement System

Department: Revenue Cycle

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

The Director, Process Improvement - System will engage with leadership within the BMC System and third party vendors to ensure that reporting, analytic, and process improvement resources are optimally aligned to meet specific strategic needs of the System. The Director, Process Improvement - System will be a key contributor to the overall Revenue Cycle leadership team and will participate in planning and organizational improvement initiatives.

• Directs a team of 2 managers (and indirectly 4 analysts) with the intent to grow. Plans and directs the activities of the Process Improvement team as performed by the Managers & analysts. Responsible for recruitment, hiring, performance management, training, professional development
• Coordinate internal and external resources to ensure that reasonable goals are established, adequate time is allotted to achieve optimal integration, and deadlines are met
• Oversees reporting and analytic training to BMC & BUMG System staff
• Responsible for the production and distribution of enterprise revenue cycle performance reporting; serves as a subject matter expert on data analytics
• Serves as a member and acts as a resource to various committees including but not limited to Revenue Cycle Council & Denials Management teams
• Implement reporting and analytic strategy to decrease cost, maximize quality, and identify opportunities for improvement within revenue cycle financials
• Oversee, implement, and maintain processes for analyzing aging for all payers, and identifies opportunities for accelerating cash and reducing AR >90 days. Identifies trends denial/delay by payer
• Oversee, implement, and maintain processes for analyzing payer denials, identifies and implements prevention opportunities for reducing denials and increasing revenue
• Work with revenue cycle vendors to discover and document the root cause of any related risk management deficiencies and formulating and documenting corrective action plans and related monitoring and reporting to protect against occurrence of such failures.
• Manages the prioritization efforts for analytics & reporting through the Revenue Cycle prioritization structure
• Understands the evolving business and analytics needs at BMC, BUMG and at peer organizations within the system
• Keep abreast of the latest advances in reporting and analytics across all industries and set the vision for how the toolset in the BMC and BUMG System should evolve
• Plans, manages and oversees projects, utilizing recognized project management methodologies
• Wherever possible, develops plans to reduce redundancy between hospital and physician billing.
• Responsible for developing, reviewing, reporting, monitoring, and enhancing performance on matters pertaining to revenue cycle management
• Oversees the creation of customized reports as requested by system leaders, and coordinates training for core users on reporting tools
• Devises and recommends new or modified approaches to reporting to improve financial and statistical reporting
• Leads projects outside original scope of work as needed to maintain a high performing revenue cycle
• Performs other duties as assigned by the Executive Director, Revenue Cycle Transformation

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

REQUIRED EDUCATION AND EXPERIENCE:

• Bachelor's degree in finance, business, healthcare or related field; and at least 10 years’ experience in finance, revenue cycle management, or information systems, of which at least 5 years must be leadership experience. Or equivalent combination of education and experience.
• Experience within healthcare required

PREFERRED EDUCATION AND EXPERIENCE:

• Master's degree

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

• N/A

CERTIFICATES, LICENSES, REGISTRATIONS PREFERRED:

• N/A

KNOWLEDGE, SKILLS & ABILITIES (KSAs):

Technical

• Demonstrated ability in Epic
• Demonstrated super user ability in third party analytic applications
• Comprehensive knowledge of accounting, finance and business administration, and a practical knowledge of patient financial billing regulations/requirements, reimbursement, and managed care in order to understand the billing systems; review, interpret, and analyze patient financial billing reports and data; and plan, coordinate and prepare for audits
• Comprehensive understanding of patient billing policies, procedures and health insurance standards, as well as familiarity of supervisory/managerial techniques and principles, in order to control hospital financial billing activities

Project Management

• Strong demonstrated project management skills, from vision through implementation. Ability to manage multiple complex projects simultaneously
• Ability to ensure work assignments for team are completed in accordance with an established project timeline
• Ability to negotiate and acquire resources as necessary to appropriately execute on projects

Leadership

• Demonstrated leadership skills, with ability to work with multi-departmental teams and peers
• Demonstrated ability to set vision and motivate stakeholders to realize the vision
• Solid understanding of business environment and operations
• Strong analytical, problem-solving and conceptual skills
• Ability to be part of a cross-departmental and cross-functional team, and participate in the organization and execution of projects
• Excellent oral and written communication skills
• Ability to communicate effectively with both technical and non-technical people

Management

• Demonstrated ability to motivate staff to perform at the highest possible level
• Demonstrated ability to set appropriate priorities for self and staff, and to delegate appropriately
• Ability to manage effectively across multiple tasks and projects under time and resource constraints
• Ability to carefully monitor processes, organize, and maintain documentation
• Ability to take lead on projects outside original scope of work to maintain a high performing revenue cycle

Compensation Range:

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being.

NOTE : This range is based on Boston-area data, and is subject to modification based on geographic location.

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