Remote Performance Optimization Jobs in Texas (NOW HIRING)

Director, Revenue Optimization

The Director, Revenue Optimization serves as a strategic and operational leader that supports enterprise initiatives to improve charge capture performance and optimize net revenue. The Revenue Optimization team, in collaboration with other Revenue Cycle teams, strengthens Charge Description Master (CDM) accuracy and charge capture processes through targeted optimization and disciplined issue management.

Essential Functions:

• Revenue Optimization: Leads enterprise CDM and revenue capture optimization initiatives that improve performance and protect net revenue across hospitals, clinics, and employed medical groups.
• Denials Prevention: Partners with Revenue Cycle stakeholders to identify root causes and recommend solutions for CDM- and charging-related denials.
• Late Charges & Avoidable Write-Offs (AWOs): Establishes processes to identify, investigate, monitor, and mitigate late charges and charging-related avoidable write-offs (AWOs).
• Revenue Leakage Detection: Designs and implements mechanisms (e.g., analytics, controls, and processes) to detect and prevent missed charging.
• Go-Live Support: Provides project management support in collaboration with other Revenue Cycle teams, for CDM and charging-related activities associated with new hospitals, clinics, service lines, and major enterprise initiatives.
• Charge Edit Optimization: Reviews charge edits and work queue accuracy, consistency, and efficiency; identifies root causes of recurring errors; and partners with stakeholders to implement sustainable process and system improvements.
• Technology Enablement: Identifies new technology and automation that enhances and supports timely and accurate charging. Conducts vendor reviews and ROI analysis and provides recommendations to senior revenue cycle leadership. Stays abreast of Epic roadmap to identify current and upcoming capabilities that strengthen charging related processes.
• Performance Reporting: Defines and monitors metrics and reporting to measure outcomes, surface risk, and prioritize optimization work.
• Executive Communication: Provides clear updates and recommendations to senior leaders on performance, risks, and priorities.
• All Other Duties: Performs other position-appropriate duties as required in a competent, professional, and courteous manner.

Key Success Factors:

• Exceptional verbal and written communication skills, manifesting in the ability to create and edit executive-ready communications that are concise, informative, and free of spelling and grammatical errors and which inspire engagement from all levels of the organization.
• The ability to effectively manage multiple high-priority, high-visibility projects simultaneously, including informal leadership of projects not directly within the scope of responsibility.
• Ability to oversee and execute complex tasks through an organized and detail-driven approach, to problem-solve, to predict and mitigate up- and down-stream implications of actions, as well as long-term plan sustainability.
• Ability to work independently and as part of a team in a fast-paced, unpredictable, and deadline-driven environment while also managing a team of high-achieving, remote professionals. Self-motivated with ability to proactively identify and resolve issues and advance personal knowledge.
• Ability to provide leadership and guidance to direct reports, supporting growth and development while ensuring department objectives are achieved.
• Advanced knowledge of Excel and data analytics to include formulas, functions, and pivot tables in order to analyze large data sets, draw conclusions, and make and implement decisions.
• Adept in researching complex questions, providing recommendations, making decisions, and devising strategies to result in appropriate outcomes.
• Ability to understand, interpret, determine the impact of, and respond to complex instructions from state and federal governing entities, and to ensure the response to these instructions results in appropriate outcomes.
• Exceptional organizational skills.
• Maintains knowledge of CDM management and denials mitigation, along with comprehensive knowledge of healthcare billing, finance, and reimbursement.

Qualifications:

• Bachelor's degree. Bachelor's degree in business, finance, healthcare administration, or related field preferred.
• Master's degree preferred.
• 5+ years of experience in healthcare revenue cycle, revenue optimization, or related functions.
• 3+ years of leadership experience.
• Experience in a large, complex integrated health system preferred.
• Epic Hospital Billing, Professional Billing, and Chargemaster experience preferred.