PRIMARY PURPOSE

The Healthcare Enterprise Leader of Vendor Management and Self-Pay Accounts is a senior leadership role in RCM responsible for overseeing and managing Enterprise RCM vendor relationships, self-pay accounts receivable and payer underpayments from contracted third party payors with a primary objective of optimizing vendor partnerships, enhancing self-pay revenue collection, obtaining appropriate reimbursement from contracted payors and ensuring efficient operations and financial stability. This leader will develop strategies, establish processes, and lead a team to effectively manage vendors, payor adherence to contracted terms, and patient collections, while adhering to regulatory requirements and maintaining a prominent level of customer service.

MAJOR RESPONSIBILITIES 

• Responsible for the RCM enterprise vendor management strategy, including vendor alignment in all markets, vendor selection, contract negotiation, relationship management and on-going performance evaluation.
• Identify, assess, and select vendors that align with the organization's goals, ensuring cost-effectiveness, quality, and compliance.
• Foster positive relationships with vendors, establishing effective communication channels and resolving any issues or disputes that may arise.
• Monitor vendor performance metrics, track service levels, and ensure contractual obligations are met.
• Oversee self-pay collections (patient responsibility dollars) for the enterprise through a combination of in-house and outsourced strategies and workflows to optimize self-pay revenue collection, reduce bad debt and provide a positive patient financial experience.
• Monitor and research regulatory changes and propose actions to respond to changing legislation and payor regulations. Works with corporate legal, compliance, audit leaders and system operations leaders to implement compliant practices in a standardized manner and maintains documentation required for audit.
• Validate and analyze payer contracts to ensure an effective process for identifying and pursuing payment variances to enhance cash flow. Work with internal and external stakeholders to include third-party payers on resolution for identified on-going issues. Maintain positive relationships and open communication with payors.
• Ensures compliance with all applicable state and federal regulations and reporting requirements.

MANAGEMENT RESPONSIBILITIES 

• Performs human resources responsibilities for teammates which include interviewing and selection of new teammates, promotions, teammate development, performance evaluations, compensation changes, resolution of teammate concerns, corrective actions, terminations, and overall teammate morale.
• 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 Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.

Education:

• Bachelor’s Degree; Master’s preferred in Business/Healthcare administration or related field

Years of Experience: 7 years

•  Progressive leadership roles within revenue cycle operations at a large multi hospital and physician practice organization.

MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES 

• Exemplary relationship management skills that foster strong collaborative partnerships who work towards the same goals together.
• Ability to quickly adapt on a daily basis in a fast-paced environment.
• Technical abilities to solve problems and increase efficiencies through leveraging technological solutions.
• Ability to have difficult but productive conversations
• Patient focused
• Contract negotiation skills
• Financial analysis and reporting skills, with the ability to interpret data, identify trends and recommend improvements.

PHYSICAL REQUIREMENTS AND WORKING CONDITIONS 

• This position may require some travel, therefore, will be exposed to weather and road conditions.
• Operates all equipment necessary to perform the job.
• Exposed to a normal office environment.
• Primarily a remote worker