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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Information Technology



Approximate Salary:

Not Specified

Position Type:

Full Time

Director, Professional Fee Revenue Cycle - Contract To Hire - Tampa, FL

UHG - Tampa, Florida

Posted: 12/13/2018

Health care leaders turn to Optum Advisory Services (OAS) for guidance, insights and practical strategies to help assert control over their organization’s future. We are more than just consultants. We are also operators with real-world health care experience, which helps clients hardwire and sustain more meaningful results that would otherwise not be achievable. As integrators across Optum, we deliver unique client-focused strategies and impact. Our proven track record driving success across the entire health care continuum empowers clients to grow, thrive and disrupt.


As part of our elite team, you will play a pivotal role in the system development cycle and consult with end users to evaluate business requirements into design specifications. You will work with all levels of the business, ensuring IT deliverables align with business requirements, with measurable results. There's never been a more exciting time to work in health care where performance and innovation can fuel your life's best work.(sm)


Responsible for overall effective performance of Professional Fee Revenue Cycle operations including management of staff, workflow development and process improvement, staff engagement, patient experience, financial performance and billing compliance. Assists with the development of operational plans and budgets (capital and operations) and implements performance improvement strategies within the physician revenue cycle. This position is responsible for the recruitment, development and supervision of staff. Ability to apply effective communication strategies to solve and facilitate simple and complex situations which enhance the culture and performance of the physician revenue cycle. Performs all duties in a manner which promotes teamwork and reflects the mission and values of the organization.


Primary Responsibilities:

  • Patient Experience/Operational Effectiveness

    • Responsible for leadership of Professional Fee Revenue Cycle Operations. Works with leaders to organize day-to-day activities, develop and refines processes to continually improve organizational culture, billing operations and staff workflows utilizing Lean leadership tools and principles

    • Experience integrating provider enrollment and professional fee coding operations into the professional fee revenue cycle organizational structure

    • Experience with all aspects of provider enrollment, including applications, CAQH, NPI and technology solutions to process all functions

    • Experience overseeing and building provider documentation education curriculum and ongoing offering

    • Provides leadership guidance and training to staff in daily business operations to develop staff and create environment of cohesiveness, teamwork and empowerment

    • Promotes superior patient experience to engage staff in solving customer service issues

    • Works with staff to create a culture of respect for others, compassion and empathy and excellence in service. Communicates results and creates a cadence of accountability. Develops and nurtures in staff a sense of shared ownership for the patient experience

    • Extremely proficient with all electronic health record workflows and reporting and analysis. Performs routine monitoring of operational metrics and makes adjustments as needed to maintain performance to KPIs and benchmarks

    • Conducts regular huddles and monthly staff meetings. Prepares agenda and shares action plans and meeting notes with the Senior Leadership team

  • Financial Management

    • Monitors business operations performance on a daily, weekly and monthly basis. Identifies opportunities for improvement and develops plans to implement necessary changes to meet budget

    • Ensures compliance to standards with focus on staff productivity and adherence to system policies and protocols for coding, billing and compliance

    • Responsible for the monitoring of supplies and maintenance of equipment

    • Assists with the development of annual budget including business operations, staffing and capital budgets

    • Prepares all necessary information for consideration of new and replacement positions and submits for approval to the Senor Leadership team

    • Ensures accurate and timely responsibilities are carried out which impact business operations performance and communicates opportunities for improvement to Leaders, including management of work queues and bank deposits

  • Employee Engagement

    • Recruits, interviews and hires staff based on optimal skills and cultural fit. Provides comprehensive on-boarding education and support to new team members

    • Responsible for creating optimal work environment to allow for high employee engagement by sharing engagement results with staff, formulating action plan and routinely involving and communicating progress with staff

    • Ensures scheduling of staff to promote efficient business operations

    • Performs evaluation process for staff and compiles information in a timely manner.

    • Provides on-going feedback to staff of performance throughout the year with a focus on mentoring and performance improvement

    • Counsels employees in disciplinary matters and works collaboratively with Human Resources to address performance issues

  • Other Functions

    • Serves on committees and attends other meetings as requested

    • Attends meetings for the benefit of operations or personal management development and growth

    • Maintains communication with Senior Leadership team to review operational issues

Required Qualifications:

  • 3+ years of experience with the following:

    • Director/manager of Professional Fee Revenue Cycle / CBO

    • Staff Management

    • Third Party Billing, and Third Party follow up

    • Claim Edit rules and management

    • Payment Posting/ERA/ Enrollment for ERA / payment posting rules / ANSII code management

    • Provider Enrollment subject matter expert

    • Management of work stream (including CAQH site use, application completion and follow up process)

    • Coding, billing and AR process and workflow

    • Billing operations including: coding and compliance, charge entry, claim processing, receipt management, AR follow up and customer service

    • Fee schedule and contract maintenance, data analysis and reporting, staff productivity management

    • Subject Matter Expert in provider credentialing and payer enrollment

  • 2+ years of experience with the following:

    • Professional Fee Coding Department Management

    • Coding and Physician Education,  including development of education curriculum and results reporting

    • Accounts Receivable data analysis – determining meaningful performance metrics, dashboard development, using data to drive prioritization of initiatives and  ROI

    • Power Point, word-processing and spreadsheet applications

    • Electronic health record and billing software applications

  • 1+ years of experience with the following:

    • Examining and re-engineering operations and workflows and reporting operational metrics to staff and Leadership

    • Creating budgets and communicating financial information to staff and providers

Preferred Qualifications:

  • Bachelor’s degree

  • 10+ years of experience in physician revenue cycle management

  • Demonstrated flexibility to accommodate changes in workload assignments and react calmly and effectively in stressful situations

  • Ability to work independently and set priorities under minimal supervision. Ability to work within the defined values, mission and vision of the organization

  • Excellent Presentation skills and executive presence

  • Excellent written and oral communications skills necessary

  • Must have superb interpersonal skills and be able to handle difficult conversations effectively. Able to express opinions openly and honestly and provide feedback in a timely and productive manner

Technology Careers with Optum. Information and technology have amazing power to transform the health care industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life's best work.(sm)


Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.



Job Keywords:  Professional Fee Revenue Cycle;  Provider Revenue Cycle; CAQH; Payer Enrollment; Physician Billing; Medical Group; Tampa, FL, Florida

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