OVERVIEW

NHHA is committed to employee well-being and maintaining a healthy work-life integration. The information given below is intended to provide an understanding and appreciation of the workload of the job and its role within NHHA. The job description outlines the main purposes in general terms only. You may be required to carry out other duties in order to commensurate with the job. This will not change the character or purpose of the job but will be necessary to maintain high standards of business practice. This job description may be altered from time to time to meet the changing needs of the company.

JOB SUMMARY

The Director of Revenue Cycle Management and Billing Operations will lead the strategic and operational management of NHHA’s revenue cycle processes across multiple facilities. This role is critical in ensuring financial sustainability, optimizing cash flow, and enhancing patient financial experiences. The ideal candidate will possess strong leadership skills, foster team development, and drive measurable improvements in billing operations.

KEY RESPONSIBILITIES

Leadership and Strategy:

• Provide strategic direction and oversight for billing and collections staff.
• Recruit, train, develop, and manage team performance to ensure operational excellence.
• Foster a collaborative work environment that encourages innovation and professional growth.

Provide Regular Reporting to NHHA and its partner organizations:

• Work closely with the CFO to optimize billing operations and create in-depth revenue analysis and reports.
• Strategic Financial Reporting: Deliver comprehensive reports, including accounts receivable (A/R) summaries, aging analyses, denial trends, and reconciliation metrics, tailored to drive actionable insights for each partner entity and NHHA.
• Performance Analytics: Provide data-driven dashboards that highlight key performance indicators (KPIs) such as cash flow trends, claim rejection rates, and payer compliance metrics to support strategic decision-making.
• Error and Optimization Reports: Generate detailed error reports alongside predictive analytics to identify systemic issues, optimize billing processes, and reduce inefficiencies across the revenue cycle.
• Customized Insights: Develop customized financial statements, including profit and loss summaries and payment tracking reports, to align with the unique goals of partner entities while ensuring regulatory compliance.

Revenue Cycle Management:

• Provide strategic oversight of the end-to-end revenue cycle, ensuring seamless integration of billing processes with new and existing contracts to optimize cash flow, reduce inefficiencies, and enhance organizational profitability.
• Serve as a liaison and subject matter expert between Billing operations and Contracts teams, facilitating communication and collaboration.
• Support the Business Development team in a consulting capacity, providing expertise on consulting contracts that encompass major strategies around contracting, billing and other revenue-related areas of opportunity.
• Implement strategies to improve and maximize revenue generation for new and existing contracts, including new service lines related to behavioral health and urgent care service lines.
• Advise on billing processes and workflows to enhance efficiency and accuracy.
• Analyze financial data to identify opportunities for cost savings and revenue growth within contracts.
• Monitor market conditions and conduct revenue forecast analysis to suggest strategies for boosting revenue.
• Ensure compliance with revenue recognition rules and guidelines, working with management and legal teams. Ensure compliance with relevant regulations, such as HIPAA, and billing guidelines specific to the industry. Develop and maintain internal controls to safeguard financial data, mitigate risks, and support successful audits.
• Assist in the development and modification of training materials for revenue management tools.
• Generate reports and tools to provide transparency and drive continuous process improvement in revenue management.
• Evaluate the performance of various revenue streams and suggest corrective actions for underperforming areas.
• This role requires a combination of financial analysis, strategic thinking, and strong communication skills to effectively manage and optimize revenue across various departments and contracts.
• Serve as a member of the Leads team which represents the leadership team of NHHA and its nonprofit partners.

POSITION REQUIREMENTS & QUALIFICATIONS

• Bachelor’s degree in business administration, finance, economics or a related field is Preferred.
• Intimate knowledge of billing systems/platforms (NextGen experience a plus)
• Understanding of Medi-Cal and Medicare billing.
• Strong leadership and communication skills.
• Intricate knowledge of billing practices especially as it relates to CalAIM and the social services that are billable under the program.
• Ability to advise others with billing claims, authorizations and submissions and provide guidance where others are encountering barriers.
• You will be responsible for managing and collaborating on a diverse range of projects, so, you will need to be highly organized and able to manage multiple tasks simultaneously.
• You will need to be able to analyze data and trends to provide insights and recommendations to the controller and business development team.
• Passion for and commitment to NHHA's mission and the non-profit organizations it oversees.
• Collaborative and Supportive Work Environment: Promote a culture of collaboration, teamwork, and inclusivity, where colleagues support and learn from each other.
• Emphasize a positive work atmosphere that encourages open communication, idea sharing, and mutual respect.
• Be present for in-person strategic meetings once per week.
• Continuous Learning and Professional Growth: Be open to opportunities for professional development, such as workshops, training programs, and industry conferences. Engage in expanding knowledge and skills in revenue management, billing systems, and leadership through ongoing learning initiatives.
• Take advantage of opportunities for mentorship and career advancement and learn from experienced leaders within the organization.

NHHA is an equal opportunity employer and welcomes candidates from diverse backgrounds. We offer competitive salaries and benefits packages, as well as opportunities for professional growth and development.