JOB SUMMARY

The Chief Medical Officer of Revenue Cycle and Billing Compliance, in partnership with the Chief Revenue Officer (CRO), serves as the head of the University of Michigan Health (UMH) Revenue Cycle, and provides strategic direction and tactical execution oversight in support of UMH?s financial, patient satisfaction, compliance, and quality goals. Additionally, the Chief Medical Officer will work to build consensus and engage with a broad stakeholder group, including medical staff, hospital leadership, and medical group leadership to design, implement, and maintain a high performing and metric-driven institutional revenue cycle. The scope includes the AMC and Regional Network.
The Chief Medical Officer of Revenue Cycle and Billing Compliance position reports to the Executive Director University of Michigan Medical Group (UMMG) and Senior Associate Dean of Clinical Affairs, President UM Health Partners Medical Regional Group, and the Chief Financial Officer, Michigan Medicine.

REQUIRED QUALIFICATIONS*

• Doctoral degree in Medicine
• Member of Medical Staff and Medical School faculty
• Prior leadership experience, including revenue cycle or clinical operations and planning and execution as well as formulating policy, developing and implementing new strategies and procedures
• Intelligence, integrity, and communication skills necessary to establish credibility and work effectively with chief administration and academic physicians as well as other stakeholders in organizing and ensuring revenue cycle performance
• Highly oriented toward transparency, provider and staff engagement, change management, communication, and development of a high-performance culture. Is a creative and effective problem solver who demonstrates commitment to customer service excellence.
• Demonstrated aptitude for building relationships based upon team participation, integrity, trust, reliability, openness and confidence and the ability to work effectively with individuals at all levels within the organization
• A hands-on approach to management with the ability to be strategic and to see the big picture while remaining attentive to detail
• Knowledge and experience in healthcare coding with demonstrated expertise in the use of standardized coding sets including CPT and ICD10
• Demonstrated experience with coding documentation improvement efforts and initiatives
• Knowledge and understanding of Relative Value Units (RVUs) and impact on provider productivity and compensation
• Knowledge of industry clinical revenue statistical indicators for Academic Medical Centers
• Ability and willingness to exhibit behaviors consistent with standards of performance improvement and organizational values (e.g., efficiency & financial responsibility, safety, partnership & service, teamwork, compassion, integrity, and trust & respect)

DESIRED QUALIFICATIONS*

• Additional training in Finance, Business Administration, Healthcare Administration, or related field
• Knowledge of Epic System (EMR)
• Knowledge of University of Michigan Health policies and procedures

BASIC FUNCTIONS AND RESPONSIBILITIES

• Partner with the Chief Revenue Officer in the overall management of UMH Revenue Cycle operations, including:
• Patient Access
• Patient Customer Service
• Coding
• Billing
• Accounts Receivable
• Payment Posting
• Revenue Analytics
• Compliance
• Technology & Training (Support Services)
• Demonstrate and promote Michigan Medicine core values of Belonging, Access, Safety/Quality and Experience
• Work collaboratively with UMH Department leaders and School of Medicine leadership in developing and implementing systems and processes to support revenue cycle goals
• With the CRO, lead revenue improvement initiatives that span the enterprise utilizing comprehensive communication and effective change management practices
• Communicate a clear near-term and long-term plan for the revenue cycle, including measurable improvements and ongoing maintenance of key performance indicators
• Maintain an articulated vision of the required core competencies, enabling technology, and organizational design considerations which will allow UMH to thrive in the dynamic healthcare market. This vision should include an informed and current perspective on the potential impacts of healthcare reform, regulatory changes, and the overall healthcare reimbursement environment. This includes the impact of both fee-for-service and value-based care models of delivery.
• Implement effective root-cause analyses to identify areas of net revenue loss, and act swiftly to put into place corrective actions
• Serve as chief officer for billing compliance for escalated concerns from providers and revenue cycle; establish and develop a working relationship with Corporate Compliance and Office of General Counsel
• Provide direction and guidance to the Medical Directors for Clinical Documentation Integrity and Care Management at the AMC and Regional Network
• Develop and maintain rapport with insurance payers and vendors; hold external entities to contracts and a high level of performance; be familiar with payer medical policies
• Utilize detailed performance management reports to identify areas for improvement; work with other departments (i.e., Health Information Technology Systems, Finance) to meet goals
• Develop and apply appropriate analytical and financial models/tools to identify, establish, and meet/exceed key revenue cycle indicators and benchmarks.
• Provide coaching, mentorship, and direction in leadership and management principles to revenue cycle leaders, in alignment with the CRO.
• Provide strategic guidance on UMH service expansion, including:
• Input on operating models that support service enhancement, growth, and operational efficiency
• Standardization, centralization, and consolidation planning for business office functions
• Identification and realization of departmental efficiencies and cost savings
• Assisting in financial due diligence activities including current state performance, risk, and opportunity assessments
• Ensure current operating environment provides structure to incorporate future growth scenarios
• Demonstrate personal integrity, enthusiasm and empathy to internal and external customers