VP, RCM Business Operations
Nashville, TN - USA
Job Summary
OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric physician-driven and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncologys mission and vision.
Why join us This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology urology technology and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.
Job Description:
This individual will be responsible for helping coordinate the day-to-day execution of all RCM functions working with the Chief Revenue Officer (CRO) and the other RCM Vice Presidents to optimize performance ensure proactive communication with practices manage risks and issues along with the overall OO RCM team. This role will also work with the CRO to manage the operational infrastructure within RCM to support continued growth through practice
acquisition and addition this individual will drive development production and communication of KPIs and metrics usage across the RCM platform.
Responsibilities:
Operational Leadership
Work closely with the CRO and the other RCM VPs to coordinate delivery of high-quality RCM services to practices including timely and proactive communication to practice leadership.
Develop monitor improve and communicate KPIs such as days in A/R day sales outstanding (DSOs) clean claim rate denial rate and cash collections; develop dashboards and reporting cadence for executive visibility.
Embed the KPIs into everyday RCM operations such that each RCM team assesses performance based on these KPIs.
Develop action plans and work alongside the other RCM VPs to constantly drive down DSOs improve collections coordinate RCM responses to external macro-economic challenges such as vendor issues government actions or payor actions.
Coordinate internal RCM team operations including leading planning for and leading leadership meetings managing risk and issues log.
With the CRO coordinate the various end-to-end revenue cycle operations including patient access prior authorization coding charge capture billing A/R follow-up denial management and payment posting.
Oversee specialty-specific workflows such as:
Oncology: Infusion and drug billing (e.g. J-codes NDC mapping) prior
authorization for high-cost therapies Medicare Part B compliance.
Urology: Procedure bundling surgical authorization and device billing.
Surgery: Global periods modifier usage inpatient/outpatient billing distinctions.
Develop and maintain a proactive approach for RCM to stay ahead of issues or risks before they impact practice or OneOncology operations.
Ensure timely communication and coordination with other internal OneOncology teams such as Operational Regional Leadership Accounting Revenue Recognition FP&A and the Executive Team of OneOncology.
Strategic Management
Support the development and execution of RCM strategy aligned with organizational goals payer trends and reimbursement models.
Evaluate and optimize technology platforms (EHR/PM clearinghouse AI automation tools BI reporting).
Collaborate closely with finance clinical operations IT compliance and managed care teams to ensure cohesive revenue cycle integration during onboarding of new practices and service lines.
Team Leadership & Development
Manage a team of RCM leads based on team needs.
Work alongside the other RCM VPs to build a performance-based culture based on accountability reliability process excellence and continuous improvement.
Assist the other RCM VPs in hiring training and monitoring of employees joining the Corporate OneOncology RCM team.
Compliance & Risk Management
Work with other RCM VPs to ensure adherence to CMS OIG HIPAA and payer specific regulations across specialties.
Partner with Compliance and the other RCM VPs to manage and communicate audits (internal and external) corrective action plans and payer escalations.
Assist other RCM VPs to implement internal controls and QA/QC processes around clinical documentation coding accuracy and claim submission.
Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer.
Qualifications/Competencies:
Bachelors degree in Healthcare Administration Business or related field required Masters degree preferred.
10 years of progressive leadership experience in RCM with at least 5 years in a senior leadership role overseeing multi-specialty revenue cycle functions required.
Prior experience in supporting or leading RCM functions in a large organization is required.
Experience supporting a growing MSO large physician group or PE-backed healthcare platform required.
Experience integrating newly acquired practices into a centralized RCM function preferred.
Familiarity with PM/EHR systems such as OncoEMR NextGen eCW Athena EPIC etc preferred.
Customer/client service approach to every activity.
Strategic thinker with hands-on operational execution capability.
Strong financial acumen and ability to tie revenue cycle performance to enterprise-level goals.
Excellent leadership communication and change management skills.
Strong organizational skills and ability to work across multi-function organizations.
Ability to work with cross functional colleagues at the same executive level to accomplish objectives.
Ability to work in a high growth environment with regularly changing priorities.
Demonstrated ability to assess dynamic situations and cut through the noise to assess and drive priorities.
Data-driven mindset with a commitment to process excellence and compliance.
Ability and willingness to deep dive into claims denials patient authorizations to help guide team on focus areas.
Up to 40% travel
Salary Range: 180K-230K
Required Experience:
Exec
About Company
We are a network of the nation's leading oncology practices bringing the latest cancer research and treatment options to patients close to home.