Director, Revenue Cycle

Description

Director, Revenue Cycle - Central Region

Reports To: Chief Financial Officer
Scope: All Central Region Service Lines

Remote

The Director, Revenue Cycle - Central Region is a senior regional leader responsible for overseeing and optimizing end-to-end revenue cycle operations across all service lines within the Central Region. This leader is accountable for revenue integrity, billing, collections, accounts receivable, denials management, payer relations, authorization and eligibility processes, cash flow, and overall revenue cycle performance for the region.

The Director will partner closely with Finance, Operations, Clinical Leadership, Compliance, IT, and other organizational leaders to ensure accurate and timely reimbursement, improve operational efficiency, reduce revenue leakage, and provide an effective financial experience for patients, families, payers, and internal stakeholders.

This is a regional leadership role. The Director is accountable for execution and results within the Central Region and will operate within the organization's established strategy, policies, controls, systems, and performance standards. The position will lead the implementation, optimization, and continuous improvement of the processes, technology, infrastructure, and performance management systems supporting the Central Region's revenue cycle operations.

Key Responsibilities

• Regional Revenue Cycle Leadership and Execution
• Develop and execute a Central Region revenue cycle plan aligned with organizational growth, operational, and financial objectives.
• Provide leadership across the region's entire revenue cycle, including patient access, eligibility, authorizations, coding, documentation, billing, payment posting, accounts receivable, collections, denials, and appeals.
• Establish regional revenue cycle goals, key performance indicators, dashboards, and accountability structures consistent with organizational expectations.
• Identify and implement opportunities to improve revenue capture, accelerate cash collections, reduce costs, and minimize revenue leakage within the region.
• Lead continuous improvement initiatives and establish consistent, effective processes across Central Region markets, branches, and service lines.

Service-Line Revenue Optimization

• Develop deep expertise in the reimbursement models, regulatory requirements, and billing requirements applicable to each Central Region service line, including Home Health and Hospice.
• Optimize Medicare, Medicaid, Medicare Advantage, commercial, managed care, and other payer reimbursement across the region.
• Partner with Clinical and Operations leadership to improve documentation, coding, utilization, authorization, and billing accuracy.
• Ensure revenue cycle processes support the timely submission of clean claims and appropriate reimbursement.
• Monitor changes in CMS, Medicare Administrative Contractor, Medicaid, managed care, and commercial payer requirements and implement the necessary operational changes within the Central Region.

Billing, Accounts Receivable, and Collections

• Oversee timely and accurate claims submission, payment posting, reconciliation, and account follow-up across the Central Region.
• Establish and execute strategies to reduce days in accounts receivable and improve cash collections.
• Develop systematic approaches to aging accounts receivable, including the prioritization of high-dollar and high-risk accounts.
• Monitor payer performance and identify trends affecting reimbursement and cash flow.
• Establish appropriate escalation processes for unresolved accounts and payer issues.

Denials and Appeals

• Lead a proactive denial prevention and management program for the Central Region.
• Analyze denial trends by payer, reason, location, service line, clinician, and process.
• Develop and implement root-cause remediation strategies to reduce preventable denials.
• Oversee appeals and recovery efforts to maximize collectible revenue.
• Establish measurable denial-rate, overturn-rate, and recovery goals for the region.

Revenue Integrity and Compliance

• Partner with Compliance, Clinical, Finance, and Operations teams to support accurate coding, billing, documentation, and reimbursement.
• Identify and mitigate revenue leakage and billing compliance risks within the Central Region.
• Ensure regional processes comply with applicable federal and state regulations, payer requirements, and organizational policies.
• Implement and maintain controls to identify billing discrepancies, underpayments, missed charges, and inappropriate payments.

Payer and Contract Management

• Partner with the CFO, contracting teams, and other appropriate organizational leaders to evaluate payer performance and reimbursement opportunities affecting the Central Region.
• Analyze payer contracts, reimbursement trends, underpayments, and payment variances.
• Support payer negotiations through data-driven analysis and revenue cycle expertise.
• Establish and oversee regional processes for identifying and recovering contractual underpayments.

Technology, Data, and Automation

• Evaluate and optimize the Central Region's use of approved revenue cycle technology, billing systems, EHR functionality, clearinghouse processes, and reporting tools.
• Identify opportunities for automation, artificial intelligence, workflow redesign, and system integration, and recommend improvements to the CFO, IT, and other appropriate leaders.
• Lead the regional implementation and adoption of approved technology and process improvements.
• Develop reliable regional revenue cycle reporting and dashboards that provide actionable insights to financial, executive, clinical, and operational leaders.
• Partner with IT and vendors to optimize system performance, resolve regional issues, and maintain data integrity.

Regional Team Leadership

• Build, develop, and retain a high-performing Central Region revenue cycle team.
• Establish clear roles, performance expectations, productivity standards, and accountability.
• Develop talent pipelines and succession plans for key regional revenue cycle functions.
• Foster a culture of ownership, continuous improvement, collaboration, compliance, and measurable results.
• Provide regular reporting to the CFO and other appropriate leaders regarding Central Region revenue cycle performance, risks, trends, and opportunities.

Key Performance Measures

• The Director will be accountable for improving and sustaining Central Region performance across measures including:
• Net revenue and cash collections
• Days in accounts receivable
• Accounts receivable aging, including balances greater than 90 days
• Clean claim rate
• Initial denial rate
• Denial overturn and recovery rate
• Net collection rate
• Gross and net days in accounts receivable
• Charge lag and billing lag
• Cash-to-net-revenue ratio
• Underpayment identification and recovery
• Bad debt and revenue leakage
• Authorization and eligibility performance
• Cost to collect
• Revenue cycle productivity
• Staffing efficiency

Qualifications

• Bachelor's degree in healthcare administration, finance, business, accounting, or a related field required; master's degree preferred.
• Ten or more years of progressive healthcare revenue cycle leadership experience, with significant experience in Home Health, Hospice, post-acute care, or another complex healthcare environment.
• Demonstrated experience leading regional, divisional, or multi-site revenue cycle operations and managing multidisciplinary teams.
• Strong understanding of Medicare, Medicaid, Medicare Advantage, commercial insurance, managed care, and other healthcare reimbursement models.
• Demonstrated success improving accounts receivable, collections, denials, cash flow, revenue integrity, and operational performance.
• Strong knowledge of healthcare billing, coding, claims, payer requirements, compliance, and revenue cycle technology.
• Experience with EHR, billing, clearinghouse, analytics, and revenue cycle management systems.
• Proven ability to analyze complex financial and operational data and translate findings into measurable improvement initiatives.
• Strong leadership presence and communication skills, with the ability to influence clinical, operational, financial, and executive stakeholders.

Preferred Qualifications

• Prior senior-level revenue cycle leadership experience within a multi-site Home Health and/or Hospice organization.
• Experience leading revenue cycle integration, operational improvement, or transformation during periods of rapid growth, acquisition, or geographic expansion.
• Experience working within centralized and/or shared-services revenue cycle models.
• Experience managing revenue cycle outsourcing arrangements and third-party revenue cycle management partners.
• Knowledge of Medicare PDGM, hospice reimbursement, face-to-face requirements, documentation requirements, and post-acute payer dynamics.
• Relevant professional certification, such as CRCR, CHFP, HFMA certification, or comparable credentials.