What are the responsibilities and job description for the Executive Director of Revenue Management position at Theracare INC?
Company Description
Since 1964, Indiana families have looked to Miller's Health Systems for compassionate care for their loved ones. In that time, Miller’s Health Systems has grown to become an employee-owned health care provider. As operators of nursing care and senior living properties across the state, MHS offers a wide variety of employment and professional growth opportunities. To learn more about our company, visit us at: http://www.millersmerrymanor.com/about-us.
Job Description
The Executive Director of Revenue Management oversees revenue operations across multiple nursing home facilities, ensuring accurate billing, optimal reimbursement, and compliance with Medicare, Medicaid, and private insurance policies. This role involves collaboration with accounts receivable, monitoring revenue trends, reducing claim denials, and working closely with clinical, financial, and compliance teams to optimize financial performance.
Some tasks include:
- Lead negotiations with insurance providers, including Medicare Advantage, Medicaid Managed Care, and private insurers, to secure favorable reimbursement rates.
- Maintain a comprehensive database of all active contracts, tracking key terms, expiration dates, and renewal deadlines.
- Collaborate with revenue cycle teams to ensure that negotiated contract terms are accurately reflected in billing and collections processes.
- Work collectively with the Corporate Insurance Department on prior authorization and re-authorization processes for managed care insurance products.
- Collaborate with the Insurance and Billing departments to optimize end-to-end revenue cycle processes, including patient intake, billing, coding, claims submission, and payment posting.
- Analyze reimbursement rates and payer mix to identify revenue opportunities.
- Conduct financial forecasting and budgeting related to revenue cycle performance.
- Ensure adherence to federal, state, and payer-specific regulations.
- Collaborate with legal and compliance teams to address regulatory changes affecting reimbursement.
Qualifications
Education & Experience:
- Bachelor’s degree in Nursing, Finance, Healthcare Administration, Accounting, or a related field.
- Minimum of 3-5 years of experience in healthcare revenue cycle management, preferably in a long-term care or skilled nursing facility setting.
- Experience with Medicare/Medicaid reimbursement, managed care contracts, and private insurance billing.
Skills & Competencies:
- Strong knowledge of healthcare billing, coding (ICD-10, CPT), and revenue cycle regulations.
- Proficiency in electronic health records (EHR) and revenue cycle management software.
- Excellent analytical skills with the ability to interpret financial and operational data.
- Strong leadership, communication, and problem-solving abilities.
- Ability to work cross-functionally and drive process improvements.
- Clinical experience preferred
Additional Information
Some of the benefits we offer our employee-owners are:
- Professional growth opportunities and the possibility for tuition reimbursement
- Employee Stock Ownership Plan and 401(k) matching
- Individual Health Care Reimbursement Arrangement, supplemental insurance options including dental, vision, and critical illness options
- Company paid Life Insurance, with options to purchase additional insurance
- Convenient access health care via telehealth and EAP program for mental health
- Discounts on cell phone plans, travel, and more
