Vice President, Revenue Analysis and Integrity

The Vice President Revenue Analysis and Integrity for the Mount Sinai Health System (MSHS) and the Icahn School of Medicine at Mount Sinai (ISMMS) (which includes the MSHS and the Faculty Practice Plan) is accountable for revenue performance across the medical center.  The Vice President will report to the Chief Revenue Officer of the MSHS.

The scope of the role includes overall leadership for revenue integrity and analysis teams overseeing functions across the MSHS. The VP will have direct management responsibility for the following functions across the MSHS: maintenance of charge master, monthly revenue and charge analysis, projections and forecasting, revenue compliance, charge capture and reconciliation strategy.

1. Ensures the overall revenue strategy aligns with/supports business objectives and is focused enterprise-wide to maximize revenue performance.
2. Leads the effort to secure accurate and timely charge capture. 
3. Organizes routine meetings with health system business leaders and managed care to review charge and revenue capture and performance. 
4. Builds effective, collaborative relationships with key stakeholders across departments (e.g., DTP, Human Performance, Managed Care, Finance, and clinical departments)
5. Collaborates with finance, managed care and DTP contributors to develop and operationalize optimal revenue capture, performance and trending.
6. Advises on charging strategy and charging standardization.
7. Provides leadership and supports governance processes to result in effective, efficient, standardized, and compliant practices across the MSHS.
8. Provides leadership oversight for charge master maintenance and enhancement.
9. Investigates and resolves revenue shortfalls and coordinates efforts to provide innovative strategies and solutions.
10. Works closely with clinical leaders and supply chain to evaluate revenue impact and charging for new technology, creates ROI analyses, and provides recommendations.
11. Establishes and maintains strong working relationships with Revenue Cycle leaders, key stakeholders, and fosters a strong working relationship with key strategic partners.
12. Maintains strong understanding of revenue performance metrics and payer mix and leads team in building plans to support operational departments to achieve best practice performance through strong analytical capabilities, process improvement identification, and technology enhancements.
13. Improves charging and revenue operations through technology and process improvement.
14. Effectively collaborates with finance on month end revenue performance, identifying trends and opportunities for optimization.
15. Develops long-range strategic plans revenue enhancement, utilizing trending reports, revenue projections and look-back of year over year and month over month performance. 
16. Collaborates with business owner and finance on business plans projected revenue performance and develops a revenue look back process. 
17. Develops options, communicates, and builds support for recommendations to allow the organization to meet changing environment/regulatory requirements and to ensure the MSHS receives appropriate reimbursement for services provided.
18. Leads development and implementation of consistent policies, procedures, and productivity standards to improve operations.
19. Maintains strong customer relationships with key strategic partners.
20. Ensures appropriate functional strategic partners are engaged throughout the process.
21. Monitors and provides regular reporting to senior management on key performance metrics (e.g., actual versus expected results for financial targets)
22. Brings developing issues and recommended actions to the attention of senior leadership and governance committees. 
23. Develops, maintains, and ensures compliance with standardized policies, processes, and programs throughout the MSHS. 
24. Oversees activities with Compliance to ensure communication, coordination, policies/protocols, and audits are monitored and effective.
25. Develops a high-performing team as measured through the achievement of benchmark process outcomes, audit and compliance results, financial goals, and employee satisfaction.
26. Stays current with government regulations regarding billing and charging requirements.
27. Establish goals, objectives, and budgets for assigned areas, and monitors/manages to ensure achievement once approved.
28. Ensures all HIPAA privacy and security standards are adhered to.
29. Conforms to the established policies/ procedures/ processes/ Standards of Behavior and ensures assigned staff do so as well.
30. Performs other duties as required by the CRO or other C-level officers.

 

ESSENTIAL FUNCTIONS OF POSITION:

• Ability to perform duties and responsibilities promptly and consistently with littl