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If you want to get way ahead in your career, it makes sense to be with an organization's that's way ahead of the curve. Formed in 1997, ProHealth Physicians has grown to become Connecticut’s leading primary care physician organization. With over 90 locations throughout the state of Connecticut, our family of primary care doctors and specialists care for more than 360,000 people statewide. In fact, ProHealth serves every county and provides roughly ten percent of the primary care delivered to patients in the state. We're leaders in thinking and in serving our communities. For instance, we're a C.M.S. approved Accountable Care Organization (ACO), covering over 30,000 Medicare patients associated with our community-based primary care providers. We're also nationally recognized as a NCQA Level III Medical Home. That kind of progressive leadership makes us perfect fit for OptumCare and UnitedHealth Group's expanding family of providers. This is a place where you can stay way ahead as you do your life's best work.SMThis position has overall corporate management responsibility for the performance of the organization’s revenue cycle. This position works with all areas of the group practice including central business office, primary care and specialty practice sites, practice operations team, ExpressCare centers, ancillary businesses, information technology, process improvement, coding, credentialing and finance to optimize the performance of the revenue cycle function for the group practice. The position also supports the OptumCare Network of Connecticut (OCNCT), by ensuring that payers fulfill their contractual responsibilities with respect to revenue sharing under the terms of global risk contract arrangements. This position is responsible for process measurement, benchmarking, identification and quantification of improvement opportunities and related ROI, short pay analysis and resolution and the implementation of continuous process and operational enhancements. This position will lead efforts to optimize the performance of revenue cycle components across the organization, initially through a direct reporting relationship with the Director, Central Billing Office and a dotted line relationship with the Manager, Revenue Cycle Systems, Director, Coding & Compliance and strong collaborative relationships with the Vice President of Practice Operations, Vice President of Contracting and other members of the Executive team as required. This position supports the ProHealth medical group as well as the OptumCare Network of Connecticut. Primary Responsibilities:
- Development and regular production of longitudinal organizational revenue cycle metrics and relevant benchmark data
- Ensure payer compliance with revenue terms of FFS based payer contracts by directing and managing all aspects of revenue integrity activities relating to FFS payer contracts (“short pay”)
- Work closely with contracting team to pursue findings with payers
- Optimize front office revenue cycle operations including patient registration, eligibility, and time of service cash collections
- Lead with the Director, Central Billing Office to continuously improve key process such as charge entry, payment posting, accounts receivable and collection agency processes
- Develop specialty specific capabilities to support ProHealth’s growing specialty division
- Develop and implement optimal claims coding and compliance processes for the various elements of the group practice including auditing of records
- Review and audit, as appropriate, OCNCT contracts to ensure compliance with revenue terms of those agreements
- Achieve optimal performance of revenue cycle functions across the organization and report and explain variances monthly versus appropriate benchmarks and goals
- Actively participate as member of leadership teams and participate in strategic and operation planning as directed by Chief Financial Officer
- Facilitate growth and development of assigned staff by implementing professional development and training plans, monitoring performance and providing effective coaching to help staff reach their full potential
- Work collaboratively as a member of the management team
- Facilitate effective cross-functional working relationship with central office, practice, ancillary and ancillary staff
- Work with process improvement team as needed to facilitate process improvements
- Assess and recommend changes to organizational design in order to optimize revenue cycle results
- Perform all other related duties as assigned
- Bachelor’s degree in business, healthcare administration or related field
- 10+ years of experience in physician revenue cycle operations (front-end, middle and downstream revenue cycle functions)
- 7+ years of solid management experience (i.e. employee selection, training, coaching and development as well as process management)
- Knowledge of current regulatory, market and consumer trends driving physician revenue cycle innovation
- Proven ability to work in a matrix environment to drive the achievement of results
- Demonstrated ability to think innovatively and deliver high-quality results
- Strong verbal and written communication skills are required.
- Possess excellent problem-solving skills. Ability to work efficiently under stressful conditions.
- Strong customer service skills.
- Strong interpersonal skills, establishing rapport and working well with others.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity 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: VP Revenue Cycle, CT, Farmington, Connecticut