Manager of Clinical Revenue Operations Cycle

The Manager of Clinical Revenue Operations Cycle is a full-time, 12-month position that is responsible for overseeing the comprehensive revenue cycle management process for clinical programs within the university. This role ensures optimal financial performance through strategic planning, operational excellence, and regulatory compliance while supporting the university's academic mission and development goals.

The position reports to the VP of Financial Affairs and University Development, and oversees the revenue cycle operations, payor credentialing, and patient accounts team. This role will also work closely with the leadership of HPU Health, including the HPU Health Managers.

QUALIFICATIONS

Education

Bachelor's degree in Business Administration, Finance, Healthcare Administration, or related field

Preferred- either a Master’s Degree in Health Sciences/related field or Master’s Degree in Business/Healthcare administration

Experience and Training

5-7 years of progressive experience in healthcare revenue cycle management across multiple clinical disciplines

3+ years of supervisory or management experience

Experience in dental revenue cycle operations, payor credentialing, and patient accounts in multi-group settings

Knowledge of academic medical center operations preferred

Strong knowledge in contract negotiations, healthcare finance and accounting

Knowledge, Skills, Ability:

Proficiency in EPIC revenue cycle management software and electronic health records systems

Advanced knowledge of Microsoft Office Suite, particularly Excel for financial analysis

Understanding of dental practice management systems

Experience with data analysis tools and reporting platforms

Robust verbal and written communication skills

Comprehensive understanding of clinical coding and billing procedures

Knowledge of insurance regulations, Medicare, Medicaid, and commercial payer requirements across clinical disciplines

Familiarity with HIPAA and other healthcare compliance regulations

Understanding of fee schedule development and management for various clinical services

Knowledge of collection laws and patient financial assistance programs

ESSENTIAL FUNCTIONS

The candidate will be expected to perform the following duties, including but not limited to:

Strategic Revenue Management

Develops and implements revenue cycle strategies, processes, and improvement initiatives across all clinical programs to maximize billings and collections to ensure institutional sustainability

Analyzes revenue cycle data to identify trends, discrepancies, and opportunities for financial improvement across multiple clinical disciplines

Designs and maintains fee schedules to optimize revenue and reduce claim denials

Establishes and monitors key performance indicators including Days in Accounts Receivable (DAR), claim denial rates, and collection rates across all clinical services

Creates comprehensive financial reports and present findings to senior leadership

Operational Oversight

Directs daily operational activities for end-to-end revenue cycle performance across all clinical services

Ensures billing practices align with healthcare regulations and standards, including accurate coding, documentation, and charge capture for each clinical discipline

Develops efficient process workflows and production team assignments to maximize operational effectiveness across multiple clinical areas

Manages patient billing cycles for all clinical services

Oversees insurance verification, pre-authorization processes, and claims submission procedures for various clinical specialties

Responsible for collecting, evaluating, and presenting operational data and performance analytics to the Chief Dental Officer and Executive Leadership Team.

Compliance and Regulatory Management

Ensures adherence to all federal, state, and local healthcare regulations, including HIPAA compliance

Monitors and responds to legislative and regulatory billing changes affecting dental revenue operations

Maintains expertise in coding standards across clinical disciplines (CDT for dental, CPT for optometry, etc.) and respective insurance regulations

Conducts regular audits to ensure compliance with payer rules and internal policies across all clinical programs

Team Leadership and Development

Supervises and manages revenue cycle staff, including billing specialists, collections personnel, and administrative support

Provides ongoing education and training to staff on coding documentation rules, regulations, and best practices across multiple clinical disciplines

Builds and designs high-performance management infrastructure to support organizational growth

Conducts performance evaluations and implement professional development plans

Fosters a collaborative team environment focused on continuous improvement

Stakeholder Collaboration

Works closely with clinical operations, compliance, and academic departments to ensures seamless revenue processes

Serves as primary liaison with third-party billing partners and insurance companies

Collaborates with university development office on financial planning and reporting

Partners with academic leadership to support educational and research missions

Communicates revenue cycle performance and issues to senior management

Financial Analysis and Reporting

Maintains data integrity in all revenue cycle reporting systems

Prepares monthly, quarterly, and annual financial performance reports

Identifies and resolves billing discrepancies and collection issues

Monitors cash flow patterns and implement strategies to accelerate collections

Provides financial analysis to support strategic decision-making

ACCOUNTABILITY

VP of Financial Affairs and University Development

Evaluation: Ongoing performance reviews is conducted along with an annual assessment by the HPU Health Managers and includes input from clinical and academic operations.

For more information about this position, please contact Brian Shollenberger, Assistant Vice President for Accounting at

R0007866