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Vice President, Revenue Cycle

Vice President, Revenue Cycle

Institute of Management Accountants, Inc.Carlsbad, CA, United States
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TrueCare is a trusted healthcare provider serving San Diego and Riverside Counties, offering compassionate and comprehensive care to underserved communities. We are committed to making healthcare accessible to everyone, regardless of income or insurance status.

With a focus on culturally sensitive, affordable services, TrueCare aims to improve the health of diverse communities. Our vision is to be the premier healthcare provider in the region, delivering exceptional patient experiences through innovative, integrated care.

Reporting to the Chief Financial Officer, the Vice President, Revenue Cycle will serve as a strong leader and strategic thought partner to our CFO. This role is a member of the senior leadership team, managing the entire revenue cycle for TrueCare's multi-site community health system.

Duties & Responsibilities :

  • Apply highly developed revenue cycle management expertise, including experience working with all provider types, across the continuum of care.
  • Lead change management initiatives including continuous process and quality improvement.
  • Develop a long-range plan for maximizing cash flow from patient services and minimizing cash carried in receivables or lost through contracting processes.
  • Assist in building a culture of growth and fiscal responsibility across the organization, demonstrating how each employee can support TrueCare's financial health.
  • Serve as liaison to the Board of Directors and its committees in all revenue-related areas.
  • Promote a culture of continuous improvement and accountability, ensuring the highest level of internal and external customer service.
  • Work diligently to ensure a high level of connectivity and communication across the Finance and Billing teams.
  • Ensure the highest quality standards, including compliance with HIPAA, as well as Federal, State and third-party regulations.
  • Develop best practice revenue cycle benchmarks for Federally Qualified Health Center (FQHC) organizations and track TrueCare's performance against those benchmarks.
  • Provide insight and guidance to the Chief Financial Officer and CEO to assist in strategic financial planning for the organization.
  • Provide coaching and mentoring for team members, including professional development and succession planning.
  • Oversee training for policies and procedures for all functions related to the revenue cycle.
  • Ensure staff provide the highest level of customer service, both internally and externally.
  • Responsible for management and system setup of Payor Contracts
  • Review Payor Contracts to ensure we are maximizing revenue through automated system set up and billing.
  • Assist with monitoring financial aspects of the 340B program, including purchasing, billing, and reimbursement.
  • Support monthly and annual 340B audits and financial reconciliations to ensure compliance with HRSA and organizational policies.
  • Review and analyze 340B transactions to identify trends, discrepancies, or opportunities for program optimization.
  • Collaborate with Pharmacy, Operations, and Finance leadership to ensure accurate reporting and tracking of 340B revenue and savings.
  • Prepare financial summaries and reports for leadership related to 340B program performance.
  • Assist in developing and maintaining internal controls to safeguard program integrity and financial accuracy.
  • Support external audits, site visits, and reporting requirements as they relate to the financial aspects of the 340B program.
  • Partner with Purchasing and Pharmacy teams to ensure correct application of 340B pricing and charges.

Management & Operations :

  • Assure compliance with GAAP and maintain fiscal internal control procedures.
  • Utilize proven E-HR system experience (EPIC preferred).
  • Prepare government reports ensuring timely filings as required.
  • Assist in general audits as required by TrueCare's various funding sources.
  • Analyze data from multiple sources, including patient accounting data, claims data, and clinical data from electronic medical records to identify potential revenue cycle and operational improvements.
  • Prepare and assist with external reporting requirements including, but not limited to, Medicare cost reports, Medi-Cal reconciliation submissions, and others as needed.
  • Review and update sliding fees and fee schedules on a regular basis as well as explanation of benefit forms received through the reimbursement process.
  • Manage ad-hoc reporting and analysis and investigate issues providing explanations and interpretations.
  • Provide accurate detailed audit documentation for internal and external audits; ensure processes are compliant with billing policies and procedures.
  • Partner with the executive team and other departments to improve billing workflow.
  • Document procedures as needed.
  • Conduct a top-to-bottom review and analysis of our current revenue cycle strategy and operations; recommend changes and upgrades as needed.
  • Assist the department in getting up-to-speed with the new OCHIN EPIC system, particularly with regards to reporting functions.
  • Assess the department's current structure to ensure optimal staffing levels; provide ongoing coaching and mentoring help each individual reach their full potential.
  • Perform other related duties as assigned.
  • Required Qualifications :

  • BA in business with emphasis in accounting, business administration or public administration.
  • Minimum 10 -15 years experience in accounting, billing, and financial reporting functions, preferably in a non-profit health care environment.
  • At least five (5) years of management / leadership experience.
  • Experience working with / within Federally Qualified Health Centers.
  • Experience with negotiations and managing payor contracts.
  • Knowledge of State of California rate setting, Medicare & Medi-Cal cost reporting.
  • Desired Qualifications :

  • MBA, CPA, or CMA preferred.
  • The pay range for this role is $175,561 to $280,898 on an annual basis.

    TrueCare is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of any characteristic protected by applicable federal, state, or local law.

    Pay transparency : If you are hired at TrueCare, your salary will be determined based on factors such as education, knowledge, skills, and experience. In addition to those factors, we believe in the importance of pay equity and consider the internal equity of our current team members when determining an offer.

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    Vice President Revenue Cycle • Carlsbad, CA, United States

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