Vice President, Revenue Cycle Management
hace 26 días
Hauppauge
Job Description Vice President, Revenue Cycle Management (RCM) A career that changes lives. SightMD is a rapidly growing integrated ophthalmic provider group, extending the reach of exceptional eye care to patients across New York, New Jersey, Pennsylvania, Connecticut, and Massachusetts. With over 127 eye care providers and the convenience of 60 locations, our commitment to delivering unparalleled services is at the heart of everything we do. As we embark on our mission, we are actively seeking teammates who are eager to contribute to our legacy of eye excellence, a tradition that spans more than 50 years. Position Summary: The Vice President of Revenue Cycle Management (VP, RCM) is responsible for the organization’s end-to-end revenue cycle performance, including maximizing collections, reducing revenue leakage, improving A/R, and ensuring accurate and timely reimbursement across clinical, surgical, optical, and cash-pay services. Reporting to the Chief Financial Officer, the VP oversees revenue cycle operations, payer and provider credentialing, revenue integrity, and payer strategy. This role is responsible for improving performance across the platform, standardizing processes, reducing aged A/R, and successfully integrating acquired and new practices. Job Duties & Essential Functions: • Revenue Cycle Leadership: Lead end-to-end RCM operations across all locations and entities, including patient access, eligibility, authorization, charge capture, coding, billing, collections, payment posting, denials, appeals, and A/R. Build and develop a high-performing team and establish standardized processes and performance expectations., • A/R & Revenue Performance: Drive improvements in net collection rate, days in A/R, aged A/R, cash collections, denials, underpayments, credit balances, and refunds. Establish measurable recovery plans and identify and eliminate revenue leakage., • Payer Strategy & Contracting: Partner with the CFO on payer strategy and negotiations. Maintain payer performance analytics, model reimbursement and contract terms, support negotiations, and ensure contracted rates and terms are accurately implemented and enforced., • Credentialing & Revenue Integrity: Oversee payer/provider credentialing and enrollment, including multi-state enrollment, recredentialing, revalidation, CAQH, licensing, and expirables. Lead revenue integrity, including charge capture, charge master and fee schedule governance, coding accuracy, documentation, and coding audits., • Ophthalmology & ASC Revenue: Ensure accurate billing and reimbursement for ophthalmology and ASC services, including surgical procedures, global periods, modifiers, co-management, diagnostic testing, and buy-and-bill pharmaceuticals. Oversee optical, vision plan, elective, and cash-pay revenue processes., • M&A, Technology & Process Improvement: Lead RCM diligence and integration for acquisitions, de novo locations, and PM/EHR conversions. Own the RCM technology and automation strategy and identify opportunities to improve efficiency, reduce cost to collect, and accelerate cash., • Analytics, Compliance & Executive Reporting: Provide weekly and monthly RCM reporting, forecasting, payer analytics, and A/R reporting. Partner with Finance, Compliance, Legal, IT, and operational leadership to ensure regulatory compliance, financial accuracy, and effective risk management. Present performance and recommendations to executive leadership, the Board, lenders, and investors. Required Qualifications: • Bachelor’s degree in Finance, Accounting, Healthcare Administration, Business, or related field., • 10+ years of progressive revenue cycle experience, including 5+ years in a senior/executive leadership role., • Experience leading RCM for a multi-site physician group or health system with $150M+ in annual net patient service revenue., • Demonstrated success improving A/R, collections, denials, reimbursement, and other key RCM metrics., • Strong knowledge of professional billing, payer reimbursement, CPT/HCPCS/ICD-10 coding, revenue integrity, and government and commercial payer requirements., • Experience with payer/provider credentialing and enrollment, payer contracting, and negotiations., • Experience leading RCM integration for acquisitions and PM/EHR conversions., • Experience managing large teams and outsourced/offshore RCM partners., • Strong analytical, financial, communication, and executive presentation skills., • Ability to work in a hybrid role with regular onsite presence in Hauppauge, NY. Preferred Qualifications: • MBA, MHA, or equivalent advanced degree., • Ophthalmology, ASC, or surgical subspecialty revenue cycle experience., • Experience with buy-and-bill pharmaceuticals and optical/vision plan revenue., • Experience in a private equity-backed MSO or physician platform., • Multi-state experience, preferably NY, NJ, PA, MA or CT., • Experience with ophthalmology PM/EHR, ASC billing, credentialing, and contract management systems., • Relevant revenue cycle, coding, or ophthalmology certification. Work Schedule: • Monday - Friday, • Hybrid work environment, • Ability to work in a hybrid role with regular onsite presence in Hauppauge, NY. Salary Range: • $190,000 – $220,000 annually, commensurate with experience. Benefits: We aim to take care of our teammates the same way we take care of our patients. All SightMD employees receive the following benefits: • Medical/Prescription Drug Coverage, • Dental Insurance, • Vision Insurance, • Company Paid Term Life Insurance & Long-Term Disability, • Supplemental Insurance Benefits, • Employee Assistance Program (EAP), • Retirement Plan - 401(k), • Paid Time Off (PTO), • Paid Holidays, • Career Development Programs, • Eligibility for benefits is based on employment status Equal Employment Opportunity Statement: SightMD is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, religion, creed, age, disability, sex, gender identity or expression, sexual orientation, familial status, pregnancy, predisposing genetic characteristics, military status, domestic violence victim status, criminal conviction, and all other protected classes under federal, state and local laws. If you are an individual with a disability and need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please contact People Services at peopleservices@sightgrowthpartners.com #SMD123
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