Executive Director Revenue Cycle

Job Summary

The Executive Director of Revenue Cycle leads the end-to-end revenue cycle across Nicklaus Children's Health System. Provides oversight of front-end, mid-cycle, and back-end revenue functions and is accountable for achieving performance targets. Partners closely with operational leaders, Managed Care, Finance, IT, and external vendors to drive sustainable financial performance, operational efficiency, and a high-quality patient experience aligned with the organization's mission to deliver exceptional pediatric care.

Job Specific Duties

• Lead and optimize all components of the revenue cycle, including:

• Patient access (scheduling, registration, authorization, financial counseling)

• Case Management, Social Work, Pastoral Services, and Transfer Center

• Health information management (HIM), coding and CDI

• Revenue integrity, Charge Description Master (CDM), charge capture, and billing

• Patient financial services, A/R follow up, Appeals and Underpayments, Cash/Credit Management, and Customer Service

• Ensure seamless coordination across all functions to achieve timely and accurate revenue capture and reimbursement.

• Lead governance and performance management of the organization's outsourced revenue cycle vendor(s), inlcluding:

• Establishing and enforcing SLAs tied to key KPIs (e.g., net collection rate, AR days, denial rate)

• Conducting regular business and performance scorecard reviews

• Driving continuous improvement and corrective action plans for underperformance

• Partnering on optimization initiatives (automation, AI, workflow redesign)

• Oversee contract performance, escalation management, and alignment of vendor operations with system goals.

• Oversee key revenue cycle metrics, including, but not limited to:

• Days in AR-

• Denial rates-

• Net collection rate, including complex large balance claims-

• Bad debt performance-

• Excess/Avoidable Days

• Coding accuracy

• Point of Service Collections

• Call Center and Pre-Access Metrics: Speed to Answer, Accuracy, Authorization Days Out, etc.

• Patient Financial Experience

• Develop and maintain a structured performance reporting framework and accountability forums.

• Analyze trends and implement targeted initiatives to improve financial outcomes.

• Partner with leadership and vendor partners to define and execute a multi-year revenue cycle strategy:

• Technology optimization (e.g., EMR revenue cycle platforms, automation, analytics tools)

• Shared services and operating model design

• Integration of vendor and internal workflows

• Collaborate with IT teams and vendors to identify system enhancements and ensure alignment with business needs.

• Ensure adherence to all regulatory, payer, and compliance requirements (IRS, OIG, CMS, HIPAA, payer contracts).

• Mitigate financial risk through strong internal controls and processes.

• Lead and develop a high-performing revenue cycle organization, including internal leaders and vendor teams.

• Establish clear accountability structures, performance expectations, and training programs.

• Foster a culture of continuous improvement, collaboration, and service excellence.

• Demonstrate strong communication and collaboration skills across the enterprise.

• Partner with clinical and operational leaders to enhance transparency and the overall patient financial experience.

• Ensure patient-friendly billing practices and effective patient financial assistance programs.

Minimum Job Requirements

• Bachelor's Degree in Business or Healthcare Administration
• 7-10 years of progressive experience in the healthcare revenue cycle
• Healthcare industry financial statistical indicators experience

Knowledge, Skills, and Abilities

• Master's degree preferred.
• HFMA, AAHAM, or similar professional certification preferred.
• Epic experience preferred.
• Florida Medicaid experience preferred.
• Proven ability to lead large-scale operational and transformation initiatives.
• Deep understanding of end-to-end revenue cycle processes, including, billing, coding, reimbursement, and denial management.
• Strong leadership and communication skills.
• Experience in negotiating contracts and resolving vendor/service issues.
• Demonstrated experience managing outsourced revenue cycle vendors or shared services models.
• Knowledge of healthcare regulatory requirements and payer dynamics.