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Director Revenue Cycle, Hospital Prior Authorizations

Dean Health Plan

It's more than a career, it's a calling.MO-SSM Health Mission HillWorker Type:RegularJob Highlights:Named 150 Top Places to Work in Healthcare 2025 - Becker's Healthcare Named One of the World’s Happiest Workplace 2025 – WorkL Named One of America's Best In-State Employers 2025 - ForbesNamed One of America's Greatest Workplaces for Women 2025 – NewsweekNamed One of America’s Greatest Workplaces for Culture, Belonging & Community 2026 – Newsweek SSM Health is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through a robust and fully integrated health care delivery system. The organization’s 40,000 team members and more than 13,900+ providers are committed to providing exceptional health care services and revealing God’s healing presence to everyone they serve.​​​​​​​With care delivery sites in Illinois, Missouri, Oklahoma, and Wisconsin, SSM Health includes 23 hospitals, more than 300 physician offices and other outpatient and virtual care services, 12 post-acute facilities, comprehensive home care and hospice services, a pharmacy benefit company, a health insurance company and an accountable care organization. It is one of the largest employers in every community it serves.This position IS hybrid/remote work eligible. SSM offers hybrid/remote work within limited states which may be subject to change at any time.To request additional information, confidentially submit your interest, or nominate a fellow colleague, please contact:Angela JonesExecutive Talent View email address on click.appcast.io Summary:Directs development and implementation of practices, policies and procedures for revenue cycle activities and resources on the hospital side.Job Responsibilities and Requirements:PRIMARY RESPONSIBILITIESDeploys, monitors and upgrades analytic tools and processes.Directs use of outside consultants including contract negotiations and third party billing.Oversees development, monitoring and compliance of departmental budget(s).Supports accounts receivable and revenue valuation quarterly reviews performed by auditors. Develops revenue valuation recommendations for management.Forecasts key business metrics using analytical techniques and produce reports with meaningful impact. Ensures data quality/integrity.Advocates and follows best practice process adoption, suggests opportunities to improve operations within scope, leading to business process harmonization.Creates work plans around remediation of identified gaps. Assists in identifying and evaluating good practices, both internal and external; utilizes existing venues to foster information sharing and transfer.Responsible for management functions including activities related to staffing such as recruitment, hiring, performance evaluation, and compensation determination. Performs other duties as assigned.EDUCATIONBachelor's degreeEXPERIENCESeven years' experience, with five years' in leadershipPHYSICAL REQUIREMENTSFrequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.Frequent keyboard use/data entry.Occasional bending, stooping, kneeling, squatting, twisting and gripping.Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.Rare climbing.REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS NoneDepartment:8701390033 Pre-ServiceWork Shift:Day Shift (United States of America)Scheduled Weekly Hours:40SSM Health is an Equal Opportunity Employer. SSM Health provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law. Click here to learn more.Job SummaryJob number: R198787Profession: Administrative & Business Professionals

Vacancy posted 19 hours ago
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