At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke Health's Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
Occ Summary
The Director, Revenue Assurance, PRMO provides management oversight across all Duke Health entities for processes ensuring appropriate reimbursement is received from commercial and governmental insurers. The Director ensures that all operations align with PRMO and Duke Health goals and initiatives with an emphasis on our Balanced Scorecard objectives: Operational Performance, Customer Service, Employee Work Culture, and Financial Controls. The Director leads the department in a manner that is people and patient-centered and respectful of all stakeholders, including modeling of the PRMO's Mission, Vision, and Values.
The position will be primarily remote with occasional onsite requirements.
Work Performed
Duties and Responsibilities of this Level:
A. Plan, direct and coordinate all activities of Revenue Assurance - 70% of time spent:
Identify, communicate and align overall strategy for revenue assurance across all organizations. Develop departmental strategies to meet overall PRMO goals and performance metrics.
Oversee low payment team which identifies and resolves payments received from insurers that are not in-line with contractual terms. In addition, provide analytic support to identify root cause of low payments and communicate back to relevant people/departments within Duke Health.
Oversee centralized denial analytic support for PRMO, including root cause analysis and trending of denials by entity, department and specialty. Provide support to PRMO departments for strategies to reduce denials and write-offs
Consolidate PRMO internal reporting/data into transparent and actionable dashboards for use by internal and external stakeholders. Dashboards will support DUHS finance in understanding monthly net revenue, cash collections and denial activity.
Serve as an internal expert on payor issues/policies, reimbursement trends and denial activity with Duke Health and PRMO leadership. Assisting in leading monthly meetings to highlight issues, trends and challenges related to net revenue and cash collections.
Actively direct outsourcing and vendor relationships. Monitor cost and evaluate utilization of any vendor relationships assigned to department cost center.
Take leadership role in technology implementations affecting department. Assist in identification of new technologies that will improve financial service operations.
B. Serve as part of the overall leadership team of the Patient Revenue Management Organization as it relates to providing input on the overall strategy and vision for the Revenue Cycle - 20 % of time spent:
Develop and achieve PRMO and Departmental goals.
Develop and promote PRMO strategic Mission, Vision, and Values while emphasizing teamwork and results.
Effectively define relevant customers and stakeholders for department management and staff. Utilize trending tools and communication plan for departmental staff related to customer service measures. Ensure measurable customer service standards are part of every employee's expected job results.
Strive for excellence in Diverse and Inclusive behaviors. Invest in Diversity growth and development of management and staff by encouraging and modeling behavioral expectations on a daily basis while continuing to keep Diversity and Inclusion at the forefront.
Create and foster a department culture that provides a satisfying and enriching environment in which staff can be developed and retained. Support the PRMO Work Culture Initiatives to improve reward and recognition programs.
C. Primary responsibility for administrative functions for Revenue Assurance department including: budget development and management, departmental work culture development/maintenance; mentoring, coaching of direct reports - 10% of time spent:
Develop, review, and approve departmental budgets. Ensure appropriate use of all resources.
Communicate budget results and assist in budget management.
Support and approve system process improvements to decrease costs and improve service for applicable stakeholders
Monitor local, national, and international trends in payor trends and policies
Manage human capitol and resources-onboarding, succession planning, recruitment strategies and employee engagement
Knowledge, Skills and Abilities
Technical: Solid understanding of billing and collections workflows with specific knowledge around reimbursement and denials. General understanding of all revenue cycle functions and interrelationships. Strong analytical skills required.
Non-technical: Strong leadership presence and skills. Proven capabilities in building and leading teams. Ability to work with others in a cooperative, collaborative manner. Strong written and oral communication skills.
Systems:
Epic experience preferred
MS Office Applications (Word, Excel, Visio, Access)
Level Characteristics
All job performance relates to the strategic goals of DUHS and its entities. All DUHS staff are expected to live Duke's Core Value: Caring for our patients, their loved ones and each other. Demonstrating commitment to excellence, safety, integrity, diversity and teamwork.
8 years progressive experience in clinical/administrative/consulting responsibilities in or with a provider or payor healthcare environment is required, of which 5 of those years should be in management of people or projects. Extensive experience working with clinical providers required.
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.