VP, Middle Revenue Cycle

This is a fully remote position, open to applicants in Texas.

📋 Description

• Develop and implement the enterprise middle revenue cycle strategy encompassing HIM, CDI, HB/PB coding, CDM, charge capture, and revenue integrity.

• Create and manage a standardized operating model across hospitals and employed physician groups.

• Provide strategic oversight for enterprise CDI and collaborate with physician leadership to enhance documentation quality and compliant severity capture.

• Establish strategy and oversight for inpatient, outpatient, and professional coding operations, competency frameworks, quality auditing, and vendor performance.

• Manage DNFB and CFB drivers related to documentation, coding, and charge capture; enhance throughput and reduce backlogs.

• Enhance quality measurement, reporting, payment, and ratings programs.

• Direct enterprise revenue integrity and charge capture initiatives to prevent leakage and bolster pre-bill controls.

• Supervise CDM governance and pricing strategy in collaboration with Managed Care, Revenue Integrity, and Finance.

• Work alongside Patient Financial Services and denials teams to minimize preventable denials through proactive interventions.

• Provide middle revenue cycle expertise to support payer contracting governance.

• Ensure readiness for audits, compliance with regulations, responses to audits, corrective action plans, and monitoring processes.

• Create KPI dashboards and executive reports that encompass coding, CDI, CMI, charge capture, claim quality, and denials.

• Lead EHR, CAC/encoder, workflow automation, reporting, and analytics optimization efforts.

• Ensure uniform operating models across academic medical centers, community hospitals, and employed physician groups.

• Build, mentor, and retain high-performing teams in HIM, CDI, coding, and revenue integrity.

• Facilitate the adoption of automation to enhance efficiency, effectiveness, and accuracy.

• Oversee budgets, staffing plans, vendor relationships, and ROI for initiatives and technology investments.

• Comply with Memorial Hermann policies, procedures, safety standards, budgetary constraints, productivity goals, and quality expectations.

• Foster professional growth, ongoing education, mentorship, and departmental objectives.

• Create compassionate, personalized, safe, and efficient experiences for patients and staff.

• Perform additional duties as assigned.

⛳️ Requirements

• Bachelor’s degree in Business Administration, Finance, Accounting, Healthcare Administration, Health Information Management, or a related field, or an equivalent combination of education and experience, is required.

• A Master’s degree (MBA, MHA, MPH, MS-HIM, or equivalent) is preferred.

• Professional credentials such as RHIA, RHIT, CCS, CCS-P, CPC, CRC, CDIP, CCDS, or RN, or substantial experience overseeing mid-cycle operations including HIM, Coding, CDI, and Revenue Integrity.

• Experience with enterprise EHR and revenue cycle platforms like Epic.

• Familiarity with coding, encoder, and CAC technologies.

• Lean/Six Sigma or similar process improvement training and application in complex operations.

• Profound understanding of middle revenue cycle interdependencies.

• Strong knowledge of inpatient and outpatient reimbursement and coding regulations, including ICD-10-CM/PCS, CPT/HCPCS, MS-DRG/APC concepts, NCCI edits, modifier usage, and medical necessity documentation.

• Capability to establish enterprise governance, standardize workflows, and ensure performance accountability in a matrixed environment.

• Demonstrated change leadership in workflow redesign, operational transformation, and technology enablement.

• Progressive leadership experience in middle revenue cycle functions within a complex healthcare delivery system.

• Knowledge of federal and state regulations and payer requirements that impact documentation, coding, billing, and reimbursement.

• Familiarity with quality and payment-related program measurements, reporting, and public ratings systems.

• Ability to lead multi-site teams and drive measurable transformation.

• Data-driven performance management skills, including defining KPIs, building dashboards, and translating trends into actionable plans.

• Excellent communication and influence skills with physicians, clinical leaders, finance, compliance, and operational stakeholders.

• Experience leading internal and external audits, corrective action plans, and compliance monitoring.

• Leadership capabilities including talent development, succession planning, and building high-performing multi-site teams.

• Willingness to travel across the enterprise and between various hospital locations as required.

🏝️ Benefits

• Opportunities for professional growth and development.

• Support for mandatory/continuing education and skills competency.

• Mentorship and preceptor opportunities available.

• A safe, caring, personalized, and efficient workplace experience.

• Support for budgetary, supply management, productivity, and quality-of-service initiatives.