Healthrise is deeply committed to improving the quality of information and data within patient medical records, ensuring they are accurate, complete, and justify the services provided. Our focus on creating and implementing best-known process standards across our health systems, including coding, clinical documentation improvement, and health record management, is critical to the success of our mission.

We take pride in our core values that guide everything we do, from fostering a culture of patient and employee centricity to continuously enhancing our processes and systems for better care and outcomes.

Position Summary

We are seeking an experienced and strategic Director of Reimbursement to provide leadership and direction for multiple functional teams for one of our larger partners. This role is critical to ensuring the integrity of data and compliance across our revenue cycle, overseeing processes that impact over $15 billion in net patient service revenue. The Director will play a key role in maintaining data standards, developing tools and applications, and ensuring regulatory compliance across all RHMs.

• Provide leadership to ensure compliance with regulations and standards.
• Develop and implement strategic priorities for assigned functional teams in alignment with corporate goals.
• Lead the design, development, testing, and maintenance of applications and tools that support revenue cycle processes and financial operations.
• Oversee the budgeting, recording, and analysis of net revenue, accounts receivable reserves, and third-party reserves, including variance reporting.
• Collaborate with RHM reimbursement, budget, finance, and compliance personnel to provide guidance and support, ensuring best practices are implemented.
• Establish and maintain standards, policies, and procedures across functional teams, ensuring that practices comply with applicable laws and regulations.
• Interpret and communicate regulatory changes, providing guidance to senior leadership and RHM teams to prepare for new requirements.
• Support external audits of third-party accounting and accounts receivable reserves by ensuring functional processes are aligned with compliance standards.
• Manage the third-party balance sheet position, ensuring reserve levels are properly accounted for and maintained.
• Assist senior management with special projects and provide financial guidance to RHM management, ensuring they understand the use of financial reports.
• Maintain knowledge of Federal, State, and local laws, as well as compliance programs, to ensure adherence to ethical standards and policies.

• Minimum of 5 years of healthcare finance and/or revenue cycle experience, with in-depth knowledge of reimbursement, third-party payer contracting, and revenue cycle management.
• Bachelor’s Degree in Business or related field required.
• Strong conceptual and analytical skills with the ability to communicate complex ideas clearly and effectively.
• Comfortable operating in a collaborative, shared leadership environment.