Prime Healthcare

Acquires and reorganizes underperforming hospitals

Corporate Director - Patient Financial Services Outsourcing & Strategic Initiatives

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeFarmers Branch, TX, USANo salary listedIn-person

About the Job

Requirements

A Bachelor's degree (B.A./B.S.), a minimum of 8-10 years of related experience and/or training, or an equivalent combination of education and experience is required.
Five years of experience in an acute hospital or facility revenue cycle setting is required.
Working knowledge of the revenue cycle spectrum, including Patient Access, Coding, DNFB, Billing, and Collections, is required.
In-depth working knowledge and experience with EPIC and clearinghouses is required, preferably.
Prior experience creating and implementing enterprise controls and oversight for outsourcing vendor relationships is required.
Ability to review and negotiate vendor agreements and scopes of work to ensure alignment with business needs and strategy is required.
Strong communication and relationship management skills are required.
Ability to form collaborative working relationships is required.
Strong analytical and problem-solving skills are required, including the ability to review weekly and monthly metrics, leading and lagging key performance indicators, and own action plans.
Ability to envision and execute process and policy changes, changes in corporate culture, and alignment between enterprise strategy and individual business channel needs is required.

Responsibilities

Implement and manage the Strategic Right-sourcing Program.
Own the operating portfolio under the Outsourcing program across Revenue Cycle Management for Prime Healthcare.
Manage risk, value, and performance of outsourcing vendor relationships.
Develop and implement Patient Financial Services improvement initiatives to maximize organizational value.
Align and supplement existing Vendor Management policies and practices.
Manage multiple programs, projects, and action items concurrently to drive performance across the enterprise.
Analyze the end-to-end revenue cycle as needed.
Analyze unusual billing and collection trends through large datasets and identify opportunities for process improvement and reimbursement optimization.
Identify, trend, and own portfolios of complex claims, including third-party claims, TDRG, and zero-balance claims.
Assist in remediating denial trends, including coordination with other departments as required.
Drive programs to increase patient liability collections, including early-out, bad-debt, and primary, secondary, and tertiary placements as needed.
Drive digital transformation, patient education, and changes in payment behavior.

Desired Qualifications

Basic navigation of EPIC systems.
Experience with Change Healthcare products, including Relay Assurance.
Ability to work with large datasets and advanced Excel functions.
Proficiency in Excel, PowerPoint, and other Microsoft products.
Working knowledge of SQL and ability to run basic functions.

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

If you wish to contribute to the Prime Healthcare legacy as a Director for a hospital within our family of acute care hospitals (or one of our future hospitals), we invite you to join our network to begin exploring immediate and future opportunities.

#AppCast

Responsibilities

The Corporate Director PFS Outsourcing and Strategic Initiatives is responsible for the implementation and management of the Strategic Right-sourcing Program, actively owning the operating portfolio under the Outsourcing program across Revenue Cycle Management for all Prime Healthcare. The Corporate Director is responsible for managing risk, value, and performance of outsourcing vendor relationships as well as developing and implementing PFS improvement initiatives to maximize value for the organization. The candidate will align and supplement existing Vendor Management policies and practices. The role requires the director to be able to manage multiple programs and projects and action items concurrently to drive performance across the enterprise. The Director may be responsible for analyzing end-to-end revenue cycle, and knowledgeable around the following:

Patient Access: including preregistration, insurance verification, point-of-service collections, financial counseling, registration, self-pay to Medicaid and other programs approval and conversion

Billing/Collections: analyze, through large datasets, unusual billing/collection trends and identify opportunities for process improvement and reimbursement optimization.

Complex Claims Management: identifies, trends, and owns portfolios of complex claims, including Third party claims, TDRG, Zero Balance, and assists in the remediation of denial trends, including coordination with other departments as required.

Patient Liability Collections: including programs to drive up patient liability collections – Early out, Bad Debt, primary, secondary and tertiary placements as needed, Drive Digital transformation and patient education and payment behavior

Qualifications

1. Bachelor's degree (B.A./B.S.); a minimum of 8-10 years related experience and/or training; or equivalent combination of education and experience.2. Five (5) years of experience with acute hospital/ facility revenue cycle setting. 3. Working knowledge of the Revenue Cycle spectrum: Patient Access, Coding, DNFB, Billing, Collections4. In-depth working knowledge and experience with EPIC and Clearing houses (preferably)5. Prior experience creating and implementing enterprise controls and oversight for outsourcing vendor relationships.6. Ability to review and negotiate vendor agreements and scopes of work to ensure alignment with business needs and strategy.7. Strong communication and relationship management skills.8. Ability to form collaborative working relationships.9. Strong analytical and problem solving skills. Ability to review weekly, monthly metrics – leading and lagging KPIs and own action plans10. Ability to envision and execute; process and policy changes, change in corporate culture, alignment between enterprise strategy and individual business channel needs.

Preferred qualifications:

1. EPIC: basic navigation of systems as a minimum2. Experience with Change Healthcare products (Relay Assurance)3. Ability to work with large data sets, extremely comfortable with Excel and its functions (basic and advanced)4. Proficiency in excel, powerpoint and other Microsoft products5. Working knowledge of SQL and ability to run basic functions

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

About the Company

Prime Healthcare

Acquires and reorganizes underperforming hospitals

Prime Healthcare operates a network of hospitals and outpatient centers across the United States, concentrating on turning around financially struggling facilities. It invests in infrastructure and technology, restructures operations, and negotiates payer terms (including pursuing higher out-of-network reimbursements) to improve financial performance, and it manages both for-profit hospitals and not-for-profit facilities through the Prime Healthcare Foundation. The company aims to raise clinical quality and patient safety while expanding access in hundreds of communities, though it has faced legal and regulatory scrutiny over billing practices and service-line decisions. Its goal is to stabilize and improve the financial and clinical performance of underperforming hospitals so they can continue serving their communities.

Company size: 5,001-10,000
Company stage: Debt Financing
Total funding: $2.2B
Headquarters: Ontario, CA
Founded: 2001

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