Region VP Revenue Cycle, Northwest

				Overview:

Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area. Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person - body, mind, and spirit - in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth. Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care. We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose.

Responsibilities:

The Region VP Revenue Cycle NW is responsible for providing strategic and operational executive leadership for all Virginia Mason Franciscan Health (VMFH) administrative and clinical support functions that contribute to the capture, management and collection of patient services revenues from all payors in accordance with strategic business objectives, professional standards, and all applicable regulatory requirements. Work is strongly focused on maintaining and enhancing optimally-functioning end-to-end revenue cycle management (RCM) processes to maximize VMFH reimbursement/revenue, and facilitate achievement of overarching business and financial targets. This leader also plays a key role in RC management throughout the Pacific Northwest (PNW) Physician Enterprise Division, including business operations in Washington and Oregon.  Revenue cycle functions include:

* Charge description master, charge review, identification of missed revenue;
* Provider audits/assessments and appropriate training to maximize revenue and minimize risk;
* Claims submission; customer service;
* Cash applications (posting, reconciliation, patient/insurance credits/refunds, etc);
* Insurance follow-up/denials management, including legacy Accounts Receivable (AR);
* Contract negotiation/management with third-party payors;
* Revenue cycle integrity and advanced revenue analytics;
* Regulatory compliance/governance;
* Specialized billing, including employer services and DME/Rx RC in support of VMFH hospitals.

An incumbent provides ongoing executive leadership and oversight in the prioritization, development, implementation and
evaluation of initiatives/processes that produce optimal financial performance/productivity, maximize effective utilization
of resources, reduce operational vulnerability and strengthen the focus on RC accountability and generate a competitive
advantage for the organization. Work is performed through subordinate management who are responsible for the day-to-
day operations of assigned RC department(s), ensuring quality and staff productivity standards are met, accurate claims
submission, timely resolution of denials/denials mitigation, and maximum revenue is realized within compliant billing
processes.

As a key member of the VMFH executive leadership team, the Region VP Revenue Cycle NW participates in long-range planning, budget administration, and the formulation and implementation of systemic and operational approaches, tactics, standards and policies to facilitate achievement of strategic business objectives relating to RC operations. Work also includes: 1) leading the implementation of integrated VMFH operational metrics, controls and standards, evaluating on-going operations/results and adjusting resources and priorities to meet changing conditions; 2) Leading VMFH revenue cycle performance monitoring and improvement initiatives to create a high performing revenue cycle across front-end, middle and back-end functions; 3) partnering with Payer Strategy and Contracting to ensure contracts are optimized for revenue opportunities and that payer contractual commitments are met; 4) Standardizing and integrating transparent revenue cycle processes and reporting to include benchmarks and key performance indicators for all phases of the revenue cycle; 5) Reviewing/interpreting key indicator reports and identifying corrective actions and/or performance improvement opportunities in response to variance and trends; 6) Maximizing VMFH relationships with external vendors, identifying revenue optimization opportunities and advocating CSH's revenue cycle position on key decisions.

An incumbent participates in multidisciplinary teams, working with VMFH/CSH Leadership/management and external officials/vendors, and requiring the ability to use effective persuasion, negotiation and change management techniques to
achieve common understanding, facilitate compromise and arrive at satisfactory solutions to highly complex issues/problems.

Work requires thorough knowledge of the specialized principles and practices related to healthcare finance/revenue cycle
management, including Medicare, DSHS, Third-party payers and other agencies, as well as a comprehensive
understanding of coding/charging practices, payer contracting, billing requirements, claims processing, cost structure, patient accounting systems and other interface systems impacting these functions. Also requires the application of strong
communication/change management skills and the ability to work effectively in ambiguous/stressful situations and effectively prioritize multiple changing and conflicting demands/priorities.

Essential Job Functions:

OPERATIONS ACCOUNTABILITY

* Provides strategic direction/oversight and directs/evaluates, through subordinate management, the programs, systems, operations and resources of the VMFH RC functions to ensure that all activities are conducted in a timely
and cost-effective manner and in compliance with organizational values, professional standards, internal policies/standards/procedures and applicable regulatory requirements; ensures effective collaboration with other internal departments or external entities to address and resolve problems, share information and enhance overall effectiveness/productivity in RC processes.
* Ensures the application of consistent standards/practices relating to the function across VMFH; directs the modification of work-flow processes and/or auditing functions as necessary to improve performance/productivity and
customer service; addresses emergent issues that require executive management attention and resolves per established guidelines; ensures that RC activities, productivity, and/or quality indicators are fully documented in
accordance with VMFH guidelines and that RC systems adequately safeguard the integrity of financial transactions and reporting.
* Directs the production and distribution of reports on key performance indices and other significant benchmarking metrics to VMFH Leadership as necessary to promote awareness, address/facilitate resolution of issues and support/inform future planning activities; collaborates with other internal departments to address and resolve problems, share information and enhance overall RC effectiveness/productivity.
* Works in partnership with Payer Strategy/Contracting to keep abreast of contract specifics and to assure development/execution of beneficial contracting strategies that support optimized revenue capture; ensures processes are in place to support payer contract negotiations and to maximize incentive payments to the best advantage of the
			

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