The rewards at Healogics are immense, starting with the important work we do to change patients’ lives. We also understand that meaningful work is hard work, and we are committed to supporting and compensating our employees for the tremendous service they provide.
 

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Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. With an aging society, obesity and diabetes on the rise, and an uptick in surgical procedures, the number of patients with non-healing wounds that would benefit from expert care is dramatically increasing. As a result, the company is working to provide our differentiated, quality outcomes to as many patients that would benefit through our out-patient clinic partnerships.

The Vice President, Billing & Revenue Management is responsible for integrating and aligning the revenue cycle, payor contracting, credentialing and enrollment strategies with Healogics’ strategic objectives, including operations processes and government reimbursement trends and projections. This role leads revenue management across the organization, including the teams and functional areas of revenue cycle management, payor contracting, credentialing and enrollment. This position serves as the focal point for education on revenue management, acts as a knowledge resource, and works closely with leaders to ensure coordination of activities and strategic plans with specific focus on Process Excellence in each of these critical areas across the enterprise.

All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.

Essential Functions/Responsibilities: 

STRATEGIC BILLING SERVICES MANAGEMENT

Develop, implement, and manage efficient and effective operational policies, processes, and performance monitoring across all reimbursement service-related functions

Develop and implement billing data quality management plans, including resources, systems, and timetables, to ensure successful execution of the organization’s financial, commercial, and operational goals

Develop and manage systems to measure billing performance against established objectives

Establish and implement necessary communication strategy for the improvement and awareness of quality issues across functions

Responsible for directing all billing functions including billing, collections, denials, payment review, cash posting, refunds, and customer service

Responsible for planning, developing, and implementing strategies and procedures to optimize and ensure an efficient billing function

Partners with managed care in developing payer partner strategies and resolving payer/provider disputes

Responsible for ensuring compliance with state and Joint Commission regulations

Partner with operational and finance teams to understand an evolving business model and create billing processes that maximize timely revenue recognition and minimize customer disputes

Drive resolution and communication of issues within teams, as well as across functions, to ensure a timely and accurate billing close

STRATEGIC REVENUE MANAGEMENT

Creates Process Excellence in all Revenue Management functions through the development and execution of organizational wide strategies for payer contracting, revenue cycle management, credentialing and enrolment

Develops strategies with a focus on effective and efficient operations, leveraging of best practices, standardization of systems, driving continuous improvement, innovation, and quality

Develops and implements policies and procedures, short and long-term goals, objectives and plans to optimize all Revenue Management functions

Monitors, tracks, and evaluates federal and state legislative matters, proposed and passed federal and state legislation effecting payors and provide guidance, input and direction as to how best manage and administer such legislation impacting the organization

Partners with finance, legal, compliance and operations teams to align Revenue Management functions to meet organizational objectives

PAYOR CONTRACTING

Develops and executes the organizational wide strategy for payor contracting and implementation of associated strategies and initiatives.

Develops strategies with a focus on maximization of profitable growth, effective and efficient operations, leveraging of best practices, standardization of systems, driving continuous improvement, innovation, and quality.

Serves as the focal point for education on payor contracting issues, acts as a managed care knowledge resource, and works closely with leaders to ensure coordination of managed care activities and strategic plans with specific focus on service line expansion, commercial growth and new business development.

Assesses current managed care strategies and contracts relative to the marketplace and ensure that successful contracts are (re)negotiated using developed and maintained systems for contract evaluation, implementation and ongoing performance monitoring.

Design processes used to collaborate with payers to understand their strategies, recommend organizations for close alignment, and design narrow networks

REVENUE CYCLE

Serves as the focal point for education, knowledge and understanding of all billing, coding, and reimbursement regulations related to the wound care and hyperbaric business.

Plans and directs effective day-to-day operations of the Revenue Cycle Management team, drives targeted service levels, turnaround times, and satisfaction/quality standards.

Works to understand and optimize current revenue cycle support to each Center and provider

TEAM LEADERSHIP

Creates a culture of One Healogics through the development and management of teams passionate about driving wound care healing and prevention forward by managing a provider support service that provides quality care to all who would benefit

Demonstrates Process Excellence in all activities and holds leadership to a consistent execution of key processes, protocols, and procedures across all centers, achieving the agreed upon plans and objectives established

Creates a Patient First approach to all provider activities by ensuring all activities are done according to policy and compliantly

Speaks Up by providing timely and constructive coaching to direct reports, creating a high-performance culture

Provides oversight to the revenue cycle management team, payor contracting team, and the credentialing and enrolment teams to ensure accurate, effective methods are implemented and followed.

Performs other duties as required.

Required Education, Experience and Credentials:

Bachelor’s Degree in Finance or Health Care Administration, Master’s Degree preferred

Minimum of ten (10) years of progressively more responsible experience in leading billing and data reconciliation teams in healthcare leadership capacity in a mid to large size for profit healthcare organization

Minimum of five (5) years of senior level management experience in healthcare leadership.

Experience billing on behalf of a hospital as third-party billing agent preferred

Track record of success in establishing positive and effective relationships at all levels and functions within the organization.

Experience in high growth, fast paced businesses with complex business models

Experience in healthcare Revenue Management

Required Knowledge, Skills and Abilities:

Excellent written, verbal, and interpersonal communication skills

Experience with leading company-wide initiatives a must, including organization wide collaboration

Demonstrated ability to successfully lead multifunctional teams

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists

Demonstrated experience in building high performing billing and reconciliation teams

Ability to problem-solve while directing multiple projects

Demonstrated project management skills

Strong people leader with the ability to engage people of disparate personalities and reach a mutually desired outcome.

A quantitative orientation that is focused on accountability and results.

Ability to work within a multi-disciplinary model and serve multiple constituents while balancing and reconciling business priorities.

Ability to analyze financial and productivity implications of process changes

Ability to ensure economic feasibility and operational excellence in all functions within their scope

High caliber business acumen

Inquisitive and intellectually curious with strong critical thinking and analytical skills.

Strong consultative and influencing skills