VP, Middle Revenue Cycle

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🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🔴 Lead

👔 Vice President

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Memorial Hermann Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

🏥 Healthcare

🧘 Wellness

💰 $5M Grant on 2022-08

Healthcare Insurance • Healthcare • Wellness

Memorial Hermann Health System is a comprehensive healthcare organization that provides a wide range of medical services, including cancer care, cardiovascular services, emergency and trauma care, women’s health, and surgical services. With the largest network of emergency centers in Greater Houston, it focuses on delivering advanced healthcare and wellness programs tailored to individual needs. Memorial Hermann is committed to advancing health equity and enhancing community health through its various medical facilities and services.

📋 Description

• Establish and execute the enterprise middle revenue cycle strategy across HIM, CDI, HB/PB coding, CDM, charge capture, and revenue integrity • Design and lead a standardized operating model across hospitals and employed physician groups • Provide executive oversight of enterprise CDI and partner with physician leadership to improve documentation quality and compliant severity capture • Set strategy and oversight for inpatient, outpatient, and professional coding operations, competency frameworks, quality auditing, and vendor performance • Own DNFB and CFB drivers associated with documentation, coding, and charge capture; improve throughput and minimize backlogs • Optimize quality measurement, quality reporting, payment, and ratings programs • Lead enterprise revenue integrity and charge capture strategy to prevent leakage and strengthen pre-bill controls • Oversee CDM governance and pricing strategy in partnership with Managed Care, Revenue Integrity, and Finance • Partner with Patient Financial Services and denials teams to reduce preventable denials through upstream interventions • Support payer contracting governance with middle revenue cycle expertise • Ensure audit readiness, regulatory compliance, audit responses, corrective action plans, and monitoring processes • Develop KPI dashboards and executive reporting covering coding, CDI, CMI, charge capture, claim quality, and denials • Lead EHR, CAC/encoder, workflow automation, reporting, and analytics optimization • Ensure consistent operating models across academic medical centers, community hospitals, and employed physician groups • Build, mentor, and retain high-performing HIM, CDI, coding, and revenue integrity teams • Facilitate automation adoption to improve efficiency, effectiveness, and accuracy • Manage budgets, staffing plans, vendors, and ROI for initiatives and technology investments • Adhere to Memorial Hermann policies, procedures, safety standards, budget, productivity, and quality expectations • Promote professional growth, continuing education, mentorship, and department goals • Create compassionate, personalized, safe, and efficient experiences for patients and the workforce • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree in Business Administration, Finance, Accounting, Healthcare Administration, Health Information Management, or related field, or equivalent combination of education and experience, required • Master’s degree (MBA, MHA, MPH, MS-HIM, or related) preferred • Professional credentials such as RHIA, RHIT, CCS, CCS-P, CPC, CRC, CDIP, CCDS, or RN, or demonstrable experience overseeing mid-cycle operations including HIM, Coding, CDI, and Revenue Integrity • Experience with enterprise EHR and revenue cycle platforms such as Epic • Experience with coding, encoder, and CAC technologies • Lean/Six Sigma or comparable process improvement training and application in complex operations • Deep understanding of middle revenue cycle interdependencies • Strong working knowledge of inpatient and outpatient reimbursement and coding rules, including ICD-10-CM/PCS, CPT/HCPCS, MS-DRG/APC concepts, NCCI edits, modifier usage, and medical necessity documentation • Ability to create enterprise governance, standardize workflows, and establish performance accountability in a matrixed environment • Proven change leadership in workflow redesign, operational transformation, and technology enablement • Progressive leadership experience in middle revenue cycle functions within a complex healthcare delivery system • Knowledge of federal and state regulations and payer requirements affecting documentation, coding, billing, and reimbursement • Knowledge of quality and payment-related program measurement, reporting, and public ratings systems • Ability to lead multi-site teams and drive measurable transformation • Data-driven performance management skills, including defining KPIs, building dashboards, and translating trends into action plans • Strong communication and influence skills with physicians, clinical leaders, finance, compliance, and operational stakeholders • Experience leading internal and external audits, corrective action plans, and compliance monitoring • People leadership capabilities including talent development, succession planning, and building high-performing multi-site teams • Ability to travel across the enterprise and different hospital sites as needed

🏖️ Benefits

• Professional growth and development opportunities • Mandatory/continuing education and skills competency support • Mentorship and preceptor opportunities • Safe, caring, personalized, and efficient workplace experiences • Budgetary, supply management, productivity, and quality-of-service support