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Vice President of Revenue Cycle Management

Vice President of Revenue Cycle Management

Lighthouse Autism CenterMishawaka, IN, US
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Job Description

Job Description

Description :

  • This is a hybrid / remote position requiring up to 20% travel to corporate office. Prefer candidates located in Indiana or Illinois.

Company Overview :

Lighthouse Autism Center is the leading Applied Behavior Analysis (ABA) therapy provider in Indiana, Michigan, Illinois, Nebraska, Iowa and North Carolina and expanding within those states and other states across the U.S. Since 2012, Lighthouse Autism Center has provided the highest quality, center-based ABA therapy to children with autism. At Lighthouse, children work on things like social skills, daily living skills, communication skills, and school-readiness skills. All children are overseen by Board Certified Behavior Analysts and programs are implemented by Registered Behavior Technicians. Lighthouse Autism Center also has full-time Speech-Language Pathologists on staff who provide co-treat and consultative services speech therapy services to children who attend the centers.

Position Overview :

The Vice President of Revenue Management serves as a key executive leader overseeing top line revenue for Lighthouse Autism Centers (LAC). This includes overall responsibility for developing payer and funding strategies, managing payer negotiations including oversight of government and legislative trends, driving efficiencies and effectiveness of departments responsible for revenue cycle functions, and managing the relationships with third party suppliers of RCM services. This position reports to the Chief Financial Officer and is a member of the Executive Leadership Team. This is an exempt, full-time position.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

  • Develops and supports the execution of revenue generation strategies, within existing and new business lines, across all payor types and government funding sources.
  • Directs all activity related to negotiating contract language, terms and rates across all payor and government contracts, striving for maximum revenue generation amidst changing market conditions and uniformity among different contracts.
  • Seeks legal and cross-function guidance as needed to ensure compliance with contracts.
  • Oversees financial modeling and analysis in partnership with internal resources to provide comprehensive financial package for decision making including fee for service rates, quality bonus programs, supplemental payments, and alternative payment methodologies as applicable.
  • Proposes contracting and pricing models and strategies using knowledge of market, local and national benchmarks, and payer market.
  • Identifies and manages technology solutions, including external partners, to understand current and future market trends influencing payor and reimbursement trends, including those for adjacent services that could impact growth opportunities.
  • Partners with VP of External Affairs to optimize government, regulatory and legislative initiatives to benefit growth and expansion geographies and relationships
  • Develops and recommends value-based methodologies and network strategy to achieve LAC’s growth objectives. Monitors methodologies and adjusts risk sharing strategies to account for changes in marketplace and contract terms.
  • Oversees insurance, credentialing and authorizations functions, whether provided internally or externally, to ensure timely and accurate processing of providers.
  • Responsible for monitoring and managing KPIs related to insurance, credentialing and authorization functions across internally and externally provided services.
  • Oversees collections and denials management leveraging internal and external resources to achieve expected collection rates.
  • Oversees updating of chargemaster on an annual basis and recommending changes to chargemaster based on environmental and contractual conditions.
  • Demonstrates strong leadership, negotiation and partnership competencies to fulfill role.
  • Requirements :

  • Bachelor’s degree in business or health care administration, Master’s preferred.
  • 10-15 years related work experience required, and 5-8 years supervisory / management experience required.
  • 5+ years of recent managed care contracting preferably in behavioral health or ABA industries.
  • Ability to use negotiating skills to communicate desired outcome, actively listen to fully understand other parties desired outcome, and find best alternatives.
  • Highly developed skills in financial analysis, contract negotiations and presentation and communication skills.
  • Ability to verbally present complex business matters to meet the needs of diverse audiences with precision, ease and grace.
  • Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.
  • Expert compliance and regulatory knowledge as related to payor and government contracts.
  • Ability to work extended hours, weekends, and holidays pursuant with industry demands.
  • Willingness to travel.
  • WORK ENVIRONMENT :

    May be a hybrid role, with a combination of working in office and home environments. Role requires occasional local and / or overnight travel – up to 20%.

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    Vice President Revenue Cycle • Mishawaka, IN, US

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