VP Revenue Cycle Management

Overview

The Vice President of Revenue Cycle Management (RCM) will lead and oversee the entire revenue cycle function for a national outpatient physical therapy organization with approximately 900 locations. This senior leader will be responsible for ensuring effective management of the front-end and back-end RCM processes, including insurance verification, authorization, denial management, patient payments, accounts receivable (A/R), and more. The VP will lead a team of internal staff and oversee relationships with several key vendors, including a large offshore vendor and specialized RCM vendors. The VP of RCM will be a strategic, innovative leader who drives continuous process improvement, automation, and efficiency, while ensuring compliance with industry regulations and improving key RCM performance indicators (KPIs).

Responsibilities

Leadership and Strategy:

• Provide leadership and direction to the entire RCM function, encompassing front-end (insurance verification, authorization, and denial management) and back-end (patient payments, accounts receivable) operations.

• Develop and implement an overarching RCM strategy that supports organizational growth, optimizes financial performance, and aligns with the company’s goals.

• Lead an internal team of approximately 45 professionals focused on customer service, vendor management, audits, and process improvement.

• Identify, develop, and execute strategies to improve key RCM KPIs, such as Days in A/R, denial rates, net collection rate, and patient satisfaction.

Vendor Management:

• Manage relationships with several RCM vendors, including a large offshore vendor responsible for authorization, A/R, and implementing automation tools.

• Oversee vendors specializing in niche areas such as workers' compensation, auto/personal injury, and other specialty claims.

• Ensure vendor performance is aligned with contractual obligations, KPIs, and business goals.

Process Improvement & Automation:

• Lead initiatives for RCM process optimization, including automation, leveraging bots, and integrating innovative technologies to streamline workflows and increase efficiency.

• Collaborate with vendors and internal teams to drive the adoption of new technologies and best practices across all RCM functions.

• Develop and execute a strategic roadmap for continuous improvement in revenue cycle processes, addressing gaps in operations and improving efficiency.

Financial Oversight & Reporting:

• Oversee all aspects of financial performance related to RCM, including cash collections, patient payments, denials, and accounts receivable management.

• Track, analyze, and report on key RCM metrics to executive leadership, identifying trends and making data-driven recommendations to improve performance.

• Collaborate closely with the finance team to ensure accurate forecasting, budgeting, and financial reporting related to revenue cycle activities.

Compliance and Risk Management:

• Ensure all RCM activities adhere to federal, state, and industry regulations, including HIPAA and other patient confidentiality laws.

• Implement and maintain audit processes to identify and mitigate risks within the RCM function, ensuring compliance and reducing potential financial exposure.

Qualifications

Minimum Education

Required:

• B.S., B.A. Healthcare Administration, Finance or Business Administration

Preferred:

• Master’s degree in Healthcare or Business Administration

Minimum Experience

Required:

• 10 years of Revenue Cycle Management

• 7 years Leadership Experience

• Previous experience supervising 75+ employees

Preferred:

• Previous experience managing off-shore vendor teams

Knowledge Skills and Abilities

• Strategic thinking and problem-solving skills

• Strong communication and negotiation abilities

• Expertise in managing offshore and third-party vendors

• Data-driven decision-making and analytical skills

• Change management experience, especially in driving automation and technology adoption in RCM functions

• Team leadership and management capabilities