Director Managed Care & Payment Integrity

Job Summary

Norman Regional Health System (NRHS) is seeking an experienced revenue cycle executive to serve as its Administrative Director of Revenue Cycle Management & Managed Care. This is a full-time, on-site leadership position responsible for the strategy, performance, and day-to-day operation of the organization’s end-to-end revenue cycle across Hospital Billing (HB), Professional Billing (PB), and

Ambulatory Services enterprises. This role will provide unified leadership over Revenue Optimization (Utilization Review & Charge Integrity), Patient Financial Services (Billing & Collections) and Managed Care (Payer Contracting & Relations). This role teams will organize teams around the revenue cycle continuum with clear ownership, accountability, and cross-department collaboration. The Administrative Director will drive net-revenue performance, accelerate cash collections, minimize avoidable write-offs, and maintain compliance, while building a data-driven, prevention-focused operating model.

The ideal candidate is a health-system revenue cycle leader with successful experience across front-end, middle, and back-end revenue functions, with strong financial and analytical acumen, and an executive presence to represent revenue cycle to the CFO, Executive Team, and Board.

Organizational Scope & Direct Reports

This position will report to the Chief Financial Officer

The Administrative Director leads multiple directors and their respective functions:

• Revenue Optimization: clinical documentation integrity (CDI), utilization review, charge integrity / charge description master (CDM), and revenue cycle analytics & KPI reporting.
• Patient Financial Services: billing and collections, cash posting, and associated customer service.
• Managed Care & Payment Integrity — payer contracting and negotiations, net-revenue reimbursement and payment integrity, denial root-cause analysis and prevention, payer escalation and relationship management, accounts receivable / underpayment recovery, and audit coordination.
  
  

Key Responsibilities

Enterprise Revenue Cycle Leadership & Strategy

• Provides a unified strategic and operational leadership for the end-to-end revenue cycle across Hospital Billing, Physician Billing, and Ambulatory Services Billing - building a single, continuum-based operating model.
• Establishes enterprise goals, budgets, and performance targets; owns overall revenue cycle results and reports performance to the CFO, Executive Team, and Board.
• Establishes and maintains clear ownership and accountability for every revenue cycle function, eliminating gaps and duplication of services across the NRHS locations and service lines.
• Drives net-revenue improvement and cash acceleration through management of A/R days, DNFB, discharged-not-final-coded (DNFC), and aged/high-dollar work-in-process (WIP) segmentation.
• Monitors and improves key revenue cycle KPIs using data-driven scorecards and dashboards to include cost-to-collect, clean-claim rate, denial rate, underpayment recovery, POS collections, bad debt and charity — using data-driven scorecards and dashboards.
• Partners with Finance on reserves, write-off governance, cost reporting, and month-end close as it relates to net revenue.
• Strengthens point-of-service collections and price-transparency / good-faith-estimate compliance.
• Ensures accurate, compliant, and timely coding, CDI, and utilization review; oversees charge integrity and CDM governance to protect expected reimbursement and reduce revenue leakage.
• Coordinates clinical denials prevention and government-audit response with clinical and denials leadership.
• Oversees billing/claims, cash posting, customer service, A/R and self-pay follow-up, and technical denials across all NRHS locations and service lines.
• Establishes productivity and quality standards, worklist discipline, and vendor performance expectations for back-end operations.
• Directs payer contracting and negotiation strategy, denial root-cause analysis and enterprise-wide denials prevention, payer escalation, and underpayment recovery.
• Provides oversight of payer relationship management, working closely with both internal and external partners.
• Manages revenue cycle vendors and platforms (e.g., EHR/billing systems, analytics, denial/underpayment, early-out and bad-debt partners); define scope, service levels, and measurable accountability, and evaluate build-vs-buy decisions.
• Recruits, develops, and retains a high-performing management team; establishes repeatable processes, SOPs, and governance for sustained performance.
• Fosters strong collaboration across clinical, financial, technological, and operational departments, including leading a regular cadence of revenue cycle governance and committee forums.
• Positions Revenue Cycle as a proactive organizational partner rather than a standalone function. Ensures consistent upstream communication and engagement so opportunities and concerns are identified and addressed before they become operational issues
• Ensures compliance with federal and state regulations, payer requirements, and organizational policy across all revenue cycle functions.
  
  

First-Year Priorities & Measures of Success

Within the first 12 months, the Administrative Director will strengthen current transformation gains, including:

• Maintaining HB DNFB at or below benchmark (≤ 6 days) and continue reducing total A/R days toward best-practice targets.
• Sustaining net-revenue and cash-acceleration performance against annual targets, with measurable reduction in avoidable write-offs and denials.
• Advancing managed-care contracting and payment-integrity capabilities in-house, reducing reliance on external vendors.
• Completing the phased integration of front, middle, and back-end functions under a single, governed operating model with clear ownership and SOPs.
  
  

Qualifications & Experience

Required:

• 10 years of revenue cycle experience in a healthcare setting, including 5 years at a director or higher level of leadership with oversight of multiple end-to-end functions across healthcare organizations with multiple service lines.
• Demonstrated results in net-revenue improvement, cash acceleration, denials reduction, and cost-to-collect performance in a hospital or health system setting.
• Experience leading and developing management teams with successful coordination and collaboration across internal and external stakeholder groups.
• Strong command of revenue cycle KPIs, analytics, and reporting, with a data-driven approach to decision making.
• Working knowledge across hospital, physician and ambulatory billing and reimbursement models, coding/CDI, charge integrity, billing, A/R, denials, and payer contracting concepts.
• Executive presence with the ability to synthesize complex information into clear recommendations for the CFO, Executive Team, and Board.
• Bachelor’s degree in Business, Healthcare Administration, Finance, or related field.
  
  

Preferred:

• Master’s degree (MBA / MHA) and relevant certifications (e.g., CRCR, CHFP, CPC/CCS, or comparable).
• Experience with Meditech and common revenue cycle / analytics platforms (e.g., FinThrive, VisiQuate, 3M).
• Experience in the Oklahoma / regional payer market and with multi-entity, multi-EHR (HB/PB/ASC) environments.
  
  

Position Structure

• This is a full-time, regular employment, on-site position based at Norman Regional Health System in Norman, Oklahoma.
• Reports directly to the Chief Financial Officer with strategic alignment and collaboration across the Executive Team.
• In the absence of the CFO, serves as the single accountable leader for enterprise-wide revenue cycle performance
  
  

Guiding Principles

• Organized around the revenue cycle continuum.
• Clear ownership and accountability.
• Strong collaboration across departments.
• Data-driven decision-making.
• Focus on prevention, accuracy, and recovery.
  
  

Work Environment & Physical Requirements

This is an on-site, office-based leadership role at Norman Regional Health System. The position may require occasional travel between NRHS facilities and extended or irregular hours during peak periods, month-end close, and key initiatives. Reasonable accommodations may be available to enable individuals with disabilities to perform the essential functions of the role.

Work Shift

Day

Position Type

Regular Full Time