Major Responsibilities: Provides overall leadership of the Revenue Cycle Managed Care Contract team in IL. Responsible for managing the Contract Modeling and over/underpayments teams. Oversees the optimization of net revenue related to reimbursement of hospital and physicians services including research and interpretation of payer regulations and contract language. Establishes, maintains and ensures the accuracy of government and managed care reimbursement formulas across IL. Oversees the payment Variance team. Responsible for the identification, follow-up and payment recovery for all accounts over/underpaid by contracted payors. Understands and communicates specific contract issues regarding payment variances to payors, APP Contract Directors and AAH executive leadership Collaborates with HIT on enhancements to system functionality to support and expand scope of modeling processes. Performs human resources responsibilities for staff which includes interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations and overall employee moral Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives. Responsible for understanding and adhering to the organization’s Code of Ethics and for ensuring that personal actions, and the actions of employees supervised, comply and policies, regulations and laws applicable to the organization’s business.

Education/Experience Required:Education Required: Bachelor's Degree (or equivalent knowledge) in Health Care Administration or related field, or Bachelor's Degree (or equivalent knowledge) in Accounting or related field. Experience Required: Typically requires 5 years of experience in revenue cycle management. Includes 1 year of supervisory experience in the management of staff, budgets, and training functions.

Knowledge, Skills & Abilities Required:Knowledge, Skills & Abilities Required: Demonstrates high performance of management skills including ability to work well with others, team building skills, organizational, communication and presentation skills. Strong background and knowledge in both hospital and physician revenue cycle operations/principles; and payor relations. Demonstrated skill in critical thinking, diplomacy and relationship building Click here to enter text. Ability to effectively manage and coordinate many different personnel responsible for contract modeling and payment variance activities Experience in executing change and results based upon data analytics and directed goal sets of the leader of billing operations. Demonstrated self-directed, results oriented and creative approach to problem solving. Ability to work with highly complex contracts and translate those into contract modeling systems Demonstrated interest in employee development, ability in interpersonal communications and sensitivity to team member needs Experience in Epic and Strata highly desired. Licensure, Registration and/or Certification Required: None Required.

Physicial Requirements and Working Conditions: Physical Requirements and Working Conditions: This position may require travel, therefore, will be exposed to weather and road conditions. Must be able to sit the majority of the workday. Exposed to a normal office or home office environment. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.



This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.