Sr. Director, Revenue Cycle Management

Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

Reporting to the VP, RCM, the Senior Director of Revenue Cycle Management (RCM) is responsible for the success of revenue cycle operations across all markets. The Sr. Director reviews and enacts policies, procedures and processes related to revenue cycle functions and holds teams accountable to established key performance metrics.This individual works closely with the senior leaders in the market as well as other operating divisions within Privia including; Finance, Analytics, Implementation, Credentialing, Performance Management, Population Health and New Product Development. The successful candidate will provide leadership to staff; communicate and model mission, vision, values and promises of Privia Health. He/she will adhere to the Privia Health Compliance Plan and privacy standards of the organization.The Sr. Director is responsible for analyzing performance against established benchmarks and providing advice and support to senior management regarding matters related to all aspects of revenue management

• Oversees and manages end to end Revenue Cycle Management for assigned markets and other national RCM projects.

• Serves as the senior subject matter expert on all issues surrounding payer reimbursement, accurate claim processing, claim submission, collections and other general revenue cycle management.

• Responsible for root cause analysis and resolution of market issues, and  escalating issues to RCM and Market Operations leadership, as necessary.

• Serves as the liaison to market or national committees such as Compliance, Payer & Audit and other committees as assigned.

• Conducts both weekly standup and monthly staff meetings. 

• Provides management, guidance and training to staff and will perform duties of staff when necessary to maintain practice operations.

• Reviews daily, monthly and weekly A/R dashboards. Identifies opportunities for improvement and develops plans to implement necessary changes to meet performance expectations.

• Participates in annual budget development, and is accountable for departmental adherence to budget and/or other fiscal goals.

• Manages teams responsible for the accuracy and financial viability of the accounts receivable. Assigns/allocates resources as required ensuring company goals for aging and accounts receivable days are met.

• Reviews accounts receivable on at least a monthly basis with each Market President and Regional Vice President to ensure A/R is within established standards.

• Works with RVPs, Market Presidents and subordinate staff to create action plans to address variances in A/R to standards.

• Responsible for departmental policies and procedures, providing recommendations when appropriate and ensuring compliance.

• Responsible for staffing to include hiring, termination, coaching and training.

• Provides ongoing feedback to staff of performance throughout the year to subordinate staff.

• Counsels employees in disciplinary matters and obtains assistance from human resources appropriately for disciplinary actions and/or employee termination process.

• Recruits, interviews and hires personnel as necessary.

Minimum Qualifications:

• Bachelor of Science/Business Administration degree preferred 

• Experience in managing physician revenue cycle. Thorough understanding of all payers including all major commercial payers as well as Medicaid and Managed Medicaid across multiple markets.

• Must have experience with AthenaHealth

• Strong and effective results-oriented team leader with a minimum of seven years of experience managing large, multi-specialty physician groups (50+) of varying levels of complexity

• Excellent analytical skills, facile with Microsoft Excel.

• Must be able to critically evaluate data and make recommendations for change based on solid research and evidence.

• Solid knowledge of industry trends, regulations, payment models and demonstrated skill in managing in a complex reimbursement model across multiple provider specialties.

• Must possess a thorough understanding of medical information systems for billing and accounts receivable, spreadsheet analysis, reporting applications, medical terminology, and coding and office procedures

• Successful history of adding value to organizations through proactive root cause analysis and resolution of bottlenecks that negatively affect reimbursement and accounts receivable

• Demonstrates a record of significantly improving patient accounts receivable

• Must comply with HIPAA rules and regulations

The salary range for this role is $128,000 - $132,000 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 15% based on performance in the role and restricted stock units. 

All your information will be kept confidential according to EEO guidelines.

Technical Requirements (for remote workers only, not applicable for onsite/in office work):

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.