VP, RCM Practice Services

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.

Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve.

Job Description:

The VP, RCM Practice Services is responsible for partnering and working closely with OneOncology’s practices across the country to oversee the development and ongoing support of revenue cycle management (RCM) strategy, oversee third party RCM vendors, and optimize RCM outcomes. This role - will be an operational expert for RCM and clinic workflows and must be able to communicate corporate and local priorities and strategies. In addition to a national focus, this position will also play a key role on optimizing our Western markets – providing a deeper level expertise on areas such as capitated payer contracts, IPAs, DOFRs, and other unique complexities of that market.

Responsibilities:

• Functions as a change agent; leads the enterprise-wide development and implementation of revenue cycle strategies that are optimal and consistent with best practice processes in healthcare.
• Serves as a liaison and provides support and information to the practice and 3rd party vendor (s) where applicable
• Assesses and responds to current and future internal and external healthcare trends (i.e. payer policy changes, government (i.e. CMS) policy changes, in order to establish and ensure the necessary direction for the revenue cycle activities.
• Maintains a collaborative, supporting relationship with management across the region and encourages collaboration between practice, corporate and 3rd party vendors that will achieve optimal patient and financial outcomes.
• Directly participates in completion of various financial forecasts, KPI analysis
• Develop and oversee quality assurance performance in partnership with vendor for training and optimizing revenue capture
• Partner with compliance on applicable regulations, standards and directives
• Identify process improvement opportunities by developing a firm understanding of workflows, best practices, and current bottlenecks.
• Co-develop with third party vendors RCM implementation plans specific to unique payer markets such as Southern California payer segment (including but not limited to: capitated contracts, IPAs, DOFRs, etc.)
• Review capitated contracts and relevant data for revenue optimization, identify leakage opportunities
• Work effectively with the Operations team to improve front office and RCM operations.
• Develop RCM KPIs that focus on collection abilities and benchmarking across the network
• Partner with finance and operations teams to evaluate collection capabilities and adherence to payer contracts.
• Develop and manage RCM KPIs that include, but are not limited to:
• Days to Bill
• Denial Rates
• Clean Claim Rates
• Percent of A/R > 90/120
• Bad Debt
• Authorization Denial Rates
• Eligibility Denial Rates
• Time of Service Collections
• Credit Balances
• DSO
• Net Collection Rates
• Accountable for complete, timely and accurate delivery of recurring tasks and month end reporting functions.
• Performs other duties as assigned to help drive our mission of improving the lives of everyone living with cancer
  
  

Qualifications/Competencies:

• 10+ years in relevant healthcare operations with Senior Level RCM experience
• Bachelor’s degree required with a Master’s Degree Preferred
• Strong verbal and written communication skills required.
• Must be detail oriented and organized.
• High integrity, including maintenance of confidential information.
• Based on business need, the ability to work a flexible schedule, including some evenings and weekends.
• Demonstrated ability to manage large teams and create a culture of high performance and accountability.
• Ability to operate in a high growth environment.