Remote Prior Authorization Rn Jobs in Murfreesboro, TN

Ardent Health is a leading provider of healthcare in communities across the country. With a focus on consumer-friendly processes and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. We are driven by our purpose of caring for people: our patients, our communities and one another.

Located in Brentwood, Tennessee, Ardent has earned a reputation as one of the industry’s strongest and most innovative healthcare systems. Our facilities and clinics are consistently recognized among healthcare’s best employers. We recognize each hospital and clinic is as unique as the community it serves. We strive to maintain strong community ties through advisory boards, contributions, charitable care, education and outreach.

Ardent includes:

• 30 hospitals
• 280 sites of care
• 4,281 beds
• 24,000+ team members
• 8,200+ nurses
• 1,800+ aligned providers
• 5.8M annual provider encounters
• 421 medical residents

Ardent makes considerable investments in people, technology, facilities, and communities, producing high quality care and extraordinary results. From newly constructed facilities and expanded services, to lifesaving technology and outstanding opportunities for employees, Ardent is committed to providing its hospitals and clinics the tools needed to succeed.

POSITION SUMMARY:

The Vice President, Revenue Cycle Management will have primary oversight of Ardent’s revenue cycle processes and revenue cycle management vendor partner. This role is accountable for the measurement and analytics of vendor performance to ensure service level agreements are met and operational effectiveness is maintained for the entire revenue cycle process including Front-End (Registration, Financial Counseling, Scheduling, Insurance Verification, Authorizations, Pre-Registration), Middle (HIM Operations, Coding and Coding Education, CDI Program Management, DRG Validation, Revenue Integrity Services) and Back-End (Billing/Claims Processing; Collections/AR Management, Cash Services/Credit Balances, Denials/Underpayments, Customer Service/Self Pay Flow, Correspondence, Dedicated Analytics). 

• Manages outsourced revenue cycle vendor relationship and serves as organization’s point of contact and liaison, both internally and externally.
• Tracks and manages performance of vendor ensuring an optimal level of performance to meet targeted KPIs and reporting metrics.
• Facilitates necessary onsite or remote business reviews with key operational stakeholders.
• Maintains awareness of organizational objectives and monitor industry developments and trends that may affect organizational direction with vendor.
• Works proactively and collaboratively to maintain strong intercompany relationships.
• Provides support in all vendor implementations and process improvement efforts.

Education & Experience:

• Bachelor's degree
• 15+ years of leadership experience in Revenue Cycle Management.
• Experience in large, multi-facility organization.
• Multi-state experience, preferred.

Knowledge, Skills & Abilities:

• Deep understanding of denials management and payor behavior
• Denials management skills that include constant monitoring with ability to pivot and address issues in a proactive manner
• Proven track record that shows ability to assess and solve NR service line optimization opportunities
• Command of prior authorization workflows and demonstrated ability to influence change
• Skilled in scheduling optimization solutions
• Chargemaster optimization
• Payor Contract compliance
• Ability to create specific service line and payor goals in a manner that provides clear roadmaps to success for our leaders
• Comfortable presenting to large audiences

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Education & Experience:

• Bachelor's degree
• 15+ years of leadership experience in Revenue Cycle Management.
• Experience in large, multi-facility organization.
• Multi-state experience, preferred.

Knowledge, Skills & Abilities:

• Deep understanding of denials management and payor behavior
• Denials management skills that include constant monitoring with ability to pivot and address issues in a proactive manner
• Proven track record that shows ability to assess and solve NR service line optimization opportunities
• Command of prior authorization workflows and demonstrated ability to influence change
• Skilled in scheduling optimization solutions
• Chargemaster optimization
• Payor Contract compliance
• Ability to create specific service line and payor goals in a manner that provides clear roadmaps to success for our leaders
• Comfortable presenting to large audiences

#LI-JK1

#LI-JK1

#LI-KS1