Vice President of Revenue Cycle Management

Rockville, MD, United States

Behavioral Framework – the leading provider of ABA therapy to children diagnosed with autism in the DMV area – is looking for a Vice President of Revenue Cycle Management (RCM) to join our team!

The Vice President of Revenue Cycle Management (RCM) is responsible for developing, optimizing, and managing a centralized revenue cycle function to support a rapidly growing and geographically expanding behavioral health provider . This role ensures excellence in the RCM department by overseeing the entire process , from provider credentialing and service authorization to claims submission and p atient and insurance collections . This hands-on leadership role requires a deep understanding of healthcare revenue cycle management, compliance with regulatory requirements, and the ability to develop and implement strategic initiatives to maximize the Company’s financial performance .

Behavioral Framework Highlights:

Behavioral Framework is devoted to the pursuit of providing excellent, honest, and compassionate care within the autism community.

We believe in the dedication and passion of our professional team and the science behind ABA to make a difference in the families and children we serve.

Ranked on the Inc. 5000 list for 3 consecutive years.

1 of 4 Autism providers in the country to earn 3-year accreditation + telehealth from the Behavioral Health Center of Excellence

Beautiful new office 2-minutes from I-270

Responsibilities

Actively oversees and works to enhance the end-to-end Revenue Cycle Management (RCM) process, touching on all key elements of RCM. This includes insurance authorization, verification and credentialing, insurance claims submissions, denials, re-submissions, insurance payment posting, patient statement distribution, collecting past due/outstanding balances.

Ensures authorizations and re-authorizations are in place for all services rendered.

Manages licensing and credentialing with a sense of urgency for all clinical employees.

Establish and implement billing, cash posting, customer service and collections standards and operating procedures across the organization

Engage in strategic planning and contribute to the overall organizational growth and sustainability through revenue cycle initiatives and best practices.

Lead and mentor a team of revenue cycle professionals, providing guidance, training, and support to drive excellence in performance and customer service.

Develop and implement strategies to optimize revenue cycle performance, reduce “leakage” and improve cash flow.

Develop and monitor key performance indicators (KPIs) and financial metrics related to revenue cycle management and identify areas for improvement.

Evaluate existing RCM solutions and if necessary lead the selection and implementation of new RCM software and solutions.

Partner with operations leaders to provide training and accountability for practice level staff.

Lead RCM integration and set up for new acquisitions and new territories.

Active participant in payer contracting and rate discussions.

Stay informed and communicate out to leadership about changes in healthcare regulations, reimbursement policies and payer changes that may impact revenue cycle operations.

Operate within the context of the federal and state regulations and guidelines, as well as those required our insurance companies as defined in their agreements and contracting guidelines.

Competencies

Planning & Project Management - Develops project plans; coordinates projects; communicates changes and progress; completes projects on time and budget. Manage multiple deadlines and changing priorities; prioritizes and plans work activities; uses time efficiently; plans for additional resources; sets goals and objectives; organizes or schedules other people and their tasks; develops realistic action plans.

Customer Orientation - Demonstrates concern for satisfying one's external and/or internal stakeholders; quickly and effectively solves problems; talks to stakeholders (internal or external) to find out what they want and how satisfied they are with what they are getting.

Quality - Demonstrates accuracy and thoroughness; seeks ways to improve and promote quality; applies feedback to improve performance; monitors own work to ensure quality. Demonstrates attention to detail. Consistently completes tasks, projects, and assignments on time.

Adaptability – Adapts to changes in the work environment; able to deal with frequent change, delays or unexpected events. Works well under stress.

Judgment - exhibits sound and accurate judgment; supports and explains reasoning for decisions.

Critical Thinking - Proactive anticipation of issues; develops solutions.

Planning/Organizing - Prioritizes and plans work activities; uses time efficiently.

Teamwork – Exhibits objectivity and openness to others' views and ideas; gives and welcomes feedback; contributes to building a positive team spirit; puts success of practice above own interests.

Interpersonal Relationships – Works to build and maintain healthy relationships with co-workers, clients, and others. Focuses on solving conflicts with win/win solutions; listens to others without interrupting; keeps emotions under control.

Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; writes clearly and informatively; reads and interprets written information.

Results -Focuses on completing essential tasks within an appropriate timeframe; is effective at setting priorities; demonstrates proficiency in both the quality and quantity of work; effectiveness of performance under pressure and/or opposition. Able to delegate responsibilities effectively.

Knowledge, Skills, Experience

Bachelor's degree in Healthcare Administration, Business Administration, or related field required; Master's degree preferred.

Minimum of 10 years of leadership experience in revenue cycle management, preferably in a behavioral health or other healthcare setting.

Proven track record of success in improving revenue cycle performance and optimizing cash flow.

Excellent knowledge of and experience with Practice Management systems.

Experience with high growth companies and acquisition integrations preferred.

Strong leadership and management skills, with the ability to effectively lead a team and drive results.

Excellent analytical and problem-solving skills, with the ability to identify issues and develop effective solutions.

Knowledge of healthcare billing regulations and compliance requirements.

Excellent communication and interpersonal skills, with the ability to collaborate effectively with internal and external stakeholders.

Work Environment, Physical Conditions

Ability to work in a fast-paced environment.

Ability to work 40+ hours per week.

Ability to do occasional travel as may be necessary.

Ability to work cooperatively with others.

Must comply with practice policies and procedures.

Primarily in office schedule only, some room for occasional remote.

Physical activities include standing for long periods of time, sitting for long periods of time, walking, bending, kneeling.

Must be able to reach, pull, and push.

Requires manual dexterity, auditory and visual skills.

Ability to lift up to 15 lbs.

EOE

Behavioral Framework is committed to equitable treatment for all employees, clients, and their families. We welcome and respect the diversity of the families we serve, and we focus our organizational efforts to build a culture of respect, dignity, fairness, caring, equality, and self-esteem.

We believe our strength comes from the shared experiences of our employees, clients, and community. We pride ourselves on serving a diverse population and always seeking to hire, retain, and promote from a wide variety of backgrounds.

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