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.
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.
Management
NCHS-REVENUE CYCLE MANAGEMENT-1000-900905
Professional
