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Position Title :Vice President, Revenue Cycle
Hiring Company :RUDISH HEALTH SOLUTIONS
Resume Recipient :Hiring Company
Job Category :Operations
Industry:Life Sciences and Health Care
Location:United States
Job I.D:14180
Nearest Metropolitan Area(s) : Detroit
Primary Location City,
State
: Toledo,OH
Description : PROMEDICA
ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. A $7 billion health network, the organization serves communities in 28 states. ProMedica offers acute and ambulatory care, an insurance company with a dental plan, and post-acute and academic business lines. The organization has more than 56,000 employees, 13 hospitals across northwest Ohio and southeast Michigan, 2,100+ physicians and advanced practice providers with privileges, 900+ healthcare providers employed by ProMedica Physicians, a health plan, and nearly 400 assisted living facilities, skilled nursing and rehabilitation centers, memory care communities, outpatient rehabilitation clinics, and hospice and home health care agencies.
As a system ProMedica:
• Sees more than 4.7 million patient encounters at 13 hospitals, four ambulatory surgery centers, and more than 400 post-acute facilities;
• Employs more than 56,000 people and over 2,100 physicians;
• Includes a physician group (ProMedica Physicians) with more than 900 providers serving more than 1.5 million patient visits annually;
• Includes a health plan, Paramount, which provides insurance to both large and small groups, as well as Medicare subscribers in northwest Ohio and southeast Michigan;
• Collaborates with educational institutions locally and regionally, offering research, grants, and residency programs, as well as fellowship, clerkship, nursing, pharmacy, allied health, and continuing education opportunities.

In 2018, ProMedica acquired HCR ManorCare, a major provider of both short-term post-acute and long-term care consisting of more than 500 skilled nursing and rehabilitation centers, assisted living facilities, outpatient rehabilitation clinics, and hospice and home health care offices. Employing over 60,000 people across over 25 states, the combined ProMedica and HCR ManorCare is the 15th largest healthcare system in the United States.
MISSION AND VALUES
ProMedica is a mission-driven organization:
• We believe you should have access to the best care right in your neighborhood — so wherever you receive care from us, you’re connected to the experience and knowledge of our entire network.
• We believe that no one is beyond the reach of life-saving health care — so every year we donate millions of dollars to provide medical services to our friends and neighbors who cannot pay.
• We believe that our neighbors are looking for ways to strengthen our communities — so we work with hundreds of volunteers who lead our boards and hospital auxiliaries to touch the lives of patients and families every day.

Mission-driven. Community-based. Not-for-profit. These are more than words. They are the principles and philosophy that drive every decision that ProMedica makes as an organization.

AWARDS AND HONORS
ProMedica is proud to be the recipient of numerous local, state, and national awards and accreditations for clinical excellence, leadership, and advocacy. Among the most recent awards are:
• Healthgrades 2019 America’s 50 Best Hospitals Award™ (ProMedica Toledo Hospital)
• 150 Top Places to Work in Healthcare, Becker’s Healthcare, 2018

(ProMedica Health System)
• 100 Most Influential People in Healthcare, Modern Healthcare, 2018

(Randy Oostra, President and CEO)
• Donald R. Newkirk Award by Ohio Hospital Association for significant lifetime contribution to the health care field in OH

(Randy Oostra, President and CEO)
• Philanthropy Ohio’s Innovations Award, 2018

(Gary Cates, Chief Philanthropy Officer)
• The Partnership for Excellence’s (TPE) 2018 Platinum, Governor's Award for Excellence

(ProMedica Memorial Hospital)
View our most recent awards and find links to read more about our award-winning services and programs here.
LIVING IN TOLEDO
Situated on the shores of the great Lake Erie, Toledo is north-western Ohio’s economic and cultural capital. With a population of around 250,000, Toledo is the fourth largest city in Ohio. It is a city with an art community, a hub for the auto assembly industry, and exciting local sports teams. The city's glass industry has earned it the nickname, "The Glass City".
Numerous cultural and recreational opportunities are available in Toledo. The Toledo Museum of Art is home to the nationally recognized Glass Pavilion, a beautiful structure housing a priceless collection of glass art. The Toledo Zoo is also nationally recognized as one of the most comprehensive in the nation and is home to the first hippoquarium. Imagination Station is a science museum whose exhibits allow a hands-on approach to learning and entertainment. Music fans in the city have a wide variety of options to enjoy, including the Toledo Opera, the Toledo Symphony, and the Toledo Ballet. Toledo's Valentine Theatre is over a century old and serves as one of the main components in the city’s downtown revitalization.
Outdoor recreation can be found in any of the more than 100 parks owned and operated by the city. Fishing and boating are plentiful on both the Maumee River, which flows through Toledo, and on Lake Erie.

REPORTING STRUCTURE
Steve Cavanaugh, Chief Financial Officer
Steve Cavanaugh is Chief Financial Officer at ProMedica. Prior to this role, he was President of HCR ManorCare, a post-acute and long-term care company acquired by ProMedica in 2018. As Chief Financial Officer, Cavanaugh is responsible for the overall financial leadership of ProMedica, including accounting, financial planning, revenue cycle, managed care, reimbursement, treasury and internal audit as well as supply chain management, process improvement and financing.
Cavanaugh earned a bachelor’s degree in finance, magna cum laude, from the University of Toledo and a master’s degree in business administration with honors from the University of Michigan. He is a native of Cuyahoga Falls, Ohio.

POSITION SUMMARY
• Responsible for oversight of hospital and physician Revenue Cycle operations;
• Responsible for central business office for hospital billing, collections, contract compliance, pre-registration, pre-certification, insurance verification, and patient financial counselling;
• Responsible for revenue enhancement and compliance activities related to the Revenue Cycle;
• Provides oversight in matrix structure for admitting and medical records;
• Provides leadership, direction, and development to staff.

SPECIFIC RESPONSIBILITIES
• Oversees the Revenue Cycle and related business unit councils to ensure operational effectiveness of medical records, admitting, and charging processes;
• Directs process improvement initiatives related to revenue cycle;
• Oversees Central Business Office for Hospitals. This includes all insurance verification, billing and collection efforts; Coordinates point of service collection systems and patient financial counseling activities; Works jointly with business unit finance liaisons on issues that affect accounts receivable and bad debt levels.
• Oversees pre-registration and pre-certification functions for PHS Hospitals; Ensures all non-emergency patients are pre-registered with appropriate authorizations prior to admission; Works closely with physician offices to insure effective communication and transmission of necessary clinical information;
• Advocacy efforts are coordinated and implemented on specific revenue cycle issues with ProMedica government relations division and are pursued through association activities and direct communication with elected officials and policy makers;
• Manages internal control systems for the revenue cycle division. This includes the development and monitoring compliance of transactional processes, including timely and accurate reporting of cash payments within the area. This also involves periodic and specific training of staff related to policies and procedures;
• Coordinates hospital coding compliance with CPT, ICD9/10, and DRG regulations;
• Provides education and coordinates audits and consulting arrangements;
• Serves as a resource for reimbursement and regulatory issues for continuing care entities;
• Hires, counsels, evaluates, and manages staff;
• Oversees Revenue Cycle reports and variance analyses for senior leadership to insure integration with financial objectives;
• Oversees Revenue Cycle technology implementation and maintenance including patient accounting systems, billing and transmission software and related programming logic, and decision support system for managed care payment modeling and analysis;
• Oversees the utilization management functions at the hospitals to ensure patients meet payer requirements and are in the appropriate level of care;
• Oversees the clinical appeals and RAC processes for the hospitals to identify denial trends and ensure communication back to key stakeholders;
• Performs all other duties as assigned.
Requirements : PROFESSIONAL EXPERIENCE AND QUALIFICATIONS
• Ten+ years of applicable experience with five years of supervisory experience required;
• Healthcare public accounting experience or healthcare industry accounting and reimbursement experience preferred;
• Excellent quantitative, analytical, and spreadsheet (Excel) utilization skills required with strong orientation to detail;
• Strong experience with managed care and governmental reimbursement methodologies, healthcare financial analysis, and knowledge of the revenue cycle required;
• Excellent communication skills with the ability to communicate effectively at multiple levels within the organization required;
• Successful track record of meeting deadlines required.


LEADERSHIP CHARACTERISTICS Mission / Vision Understands, acts on, and is dedicated to the System/BU mission and vision. Thinks and acts from a decentralized and systems perspective. Places customers, patients, and family needs before all other objectives.
Knowledge Stays informed on industry and professional/ functional level. Understands the complex issues facing the organization. Exhibits the appropriate level of industry, professional/functional knowledge, and modifies priorities and responses as necessary.
Innovation/ Creativity Creates an atmosphere that challenges the “status quo”; receptive to change/risk. Originates and adapts new ideas to achieve objectives.
Decision Making/ Judgment When possible, completes an in-depth analysis of problems, consequences, and alternative solutions before making decisions. Seeks input from others. Initial actions and decisions are timely and accurate.
Leadership/ Performance Mgt. Carefully evaluates and balances System, BU, and individual objectives. Develops and achieves challenging and attainable objectives. Engages staff in continuous evaluation and improvement.
Teamwork/ Communication Creates a climate of objectivity, cooperation, recognition, contribution, and trust. Makes and keeps commitments. Listens carefully, communicates clearly, and beyond a “need-to-know” basis. Removes obstacles and resolves conflict.
Operations/ Effectiveness Develops/adheres to budgets and plans activities to efficiently achieve objectives. Demonstrates ability to effectively plan, prioritize, and manage multiple activities. Effective steward of organizational resources.
Ethical Behavior/ Values Models the values of collaboration, compassion, excellence, and integrity. Builds honest, trusting, and respectful relationships. Shows consistency in words and actions. Does not undermine or respond negatively to others.
Professional/ Community Involvement Participates and represents the organization in community/civic activities. Influences public/private health care issues in accordance with organizational/individual ability and opportunity. Active in professional association(s).
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