VP, Revenue Strategy & Operations
Frederick Health, Frederick, Maryland, United States, 21701
Description
Job Summary
The Vice President of Revenue Strategy and Operations is an integral part of the Administrative and Revenue Cycle leadership team. They will have oversight and management of all functions of revenue cycle, including management oversight of all business-related functions of patient visits from point of contact to collection of patient service revenue. They will drive sustainable growth through advocacy and engagement with the state, Health Services Cost Review Commission (HSCRC) and Maryland Hospital Association (MHA) to bolster the position of Frederick Health for rate and policy driven initiatives. This executive leadership role optimizes technology (CRM, EHR), analytics, and processes to improve revenue integrity, compliance, and profitability. They will support and will be responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior
Key Responsibilities and Essential Functions:
Strategic Planning: Define and execute revenue strategies, including forecasting, pricing, and market expansion.
Operational Excellence: Optimize revenue cycle management (RCM) workflows, including billing, claims, and financial clearance.
Technology & Data: Lead CRM/EHR system strategy, leveraging AI and analytics to enhance data accuracy and performance reporting.
Cross-functional Leadership: Align senior leadership and service lines to ensure consistent, scalable revenue processes.
Compliance & Risk: Ensure adherence to healthcare regulations (HIPAA, payer policies) and optimize audit readiness.
Collaborates with managers and team members to ensure maximization of revenue and cash flow while maintaining the highest levels of patient, physician, and employee engagement.
Promotes standardization of business practices, remove barriers to successful operations, and ensure that regulatory requirements and standards are met.
Oversight responsibilities include:
Rev Cycle Operations - compliance with third party payer regulations and audits, customer service activities, vendor management, employee productivity and ongoing improvements to key revenue cycle indicators.
Maryland and Federal reimbursement model compliance
Payor Contracting – rate negotiation and alignment strategies, contract resolution and escalation of payment discrepancies
Value Based Care Program performance – contract monitoring and analysis, dashboard review with Medical Group and community providers through Frederick Integrated Health Network (FIHN) organization
Maryland Healthcare Specific Responsibilities:
HSCRC Rate Management: Ensure rate orders are optimized to realize the full potential of the approved Global Budget while maintaining compliance with state-mandated policies.
GBR Performance Strategy: Develop strategies to maximize GBR by reducing potentially avoidable utilization and shifting care to lower-cost settings without losing budget value.
Market Shift Oversight: Monitor and manage market shift adjustments to ensure revenue is captured or protected when patient volumes move between facilities in the service area.
Quality & Policy Alignment: Partner with clinical leadership to ensure high performance in HSCRC Quality Programs (e.g., Readmissions, Quality-Based Reimbursement), as these results directly impact the global revenue ceiling.
Capital Policy Planning: Coordinate large-scale project funding through the HSCRC Capital Policy, ensuring new projects receive appropriate rate updates and meet state efficiency standards.
Required Knowledge, Skills and Abilities:
Demonstrated extensive knowledge of third-party and insurance company operating procedures, regulations and billing requirements, and government reimbursement programs.
Excellent command of medical information systems for billing and accounts receivable, spreadsheets, reporting applications, medical terminology, coding and office procedures. Adds value to the organization through proactive analysis of and resolution to potential bottlenecks that may negatively affect the organization’s reimbursement and accounts receivable.
Demonstrated success in yielding significant results in improving patient accounts receivable.
Must possess superior communication skills, demonstrate the ability to work in a team environment, and be able to effectively integrate front and back-end work processes and personnel toward a common goal.
Ability to maintain a high level of confidentiality.
Deep knowledge of healthcare industry trends, CRM/EHR systems, financial forecasting, and change management.
Minimum Education, Training, and Experience Required: • Bachelor’s degree in Accounting, Finance, Business Administration or related field or equivalent combination of education and experience. MBA preferred.
• 10+ years in progressive revenue operations or healthcare RCM roles, with at least 5 years in senior leadership.
• Five to seven years (5-7) years’ experience in Maryland rate setting and reimbursement model management is strongly preferred.
• Experience in oversight of revenue cycle operations, both acute and ambulatory is strongly preferred.
Performance of job does not require patient contact.
Physical Demands:
Sedentary - Light Work - Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting, a certain amount of walking or standing is often necessary.
Reporting Relationship:
Reports to CFO
Caring for you as you care for the CommUNITY Frederick Health offers a comprehensive and affordable benefits package. Health, Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer multiple plans to best meet your and your family's needs. Life insurance, Short-Term Income Replacement and Long-Term Disability are employer paid for eligible employees. Frederick Health offers a robust Paid Time Off program for eligible employees. Our 403B retirement plan helps you save for your retirement and includes an employer match to eligible employees. All employees have access to free financial planning sessions. We also offer an educational assistance program to support your education goals as well as an employer paid Employee Assistance Program.
Pay is based on experience, skills and education. If position is part-time, salary will be pro-rated based on scheduled hours. The pay range may also vary within the stated range based on specialty if applicable. Non-Exempt po sitions may have shift differential and/or Overtime paid, if applicable.
Qualifications Education Required Bachelors or better.
Experience Required 10+ years in progressive revenue operations or healthcare RCM roles, with at least 5 years in senior leadership
Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
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The Vice President of Revenue Strategy and Operations is an integral part of the Administrative and Revenue Cycle leadership team. They will have oversight and management of all functions of revenue cycle, including management oversight of all business-related functions of patient visits from point of contact to collection of patient service revenue. They will drive sustainable growth through advocacy and engagement with the state, Health Services Cost Review Commission (HSCRC) and Maryland Hospital Association (MHA) to bolster the position of Frederick Health for rate and policy driven initiatives. This executive leadership role optimizes technology (CRM, EHR), analytics, and processes to improve revenue integrity, compliance, and profitability. They will support and will be responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior
Key Responsibilities and Essential Functions:
Strategic Planning: Define and execute revenue strategies, including forecasting, pricing, and market expansion.
Operational Excellence: Optimize revenue cycle management (RCM) workflows, including billing, claims, and financial clearance.
Technology & Data: Lead CRM/EHR system strategy, leveraging AI and analytics to enhance data accuracy and performance reporting.
Cross-functional Leadership: Align senior leadership and service lines to ensure consistent, scalable revenue processes.
Compliance & Risk: Ensure adherence to healthcare regulations (HIPAA, payer policies) and optimize audit readiness.
Collaborates with managers and team members to ensure maximization of revenue and cash flow while maintaining the highest levels of patient, physician, and employee engagement.
Promotes standardization of business practices, remove barriers to successful operations, and ensure that regulatory requirements and standards are met.
Oversight responsibilities include:
Rev Cycle Operations - compliance with third party payer regulations and audits, customer service activities, vendor management, employee productivity and ongoing improvements to key revenue cycle indicators.
Maryland and Federal reimbursement model compliance
Payor Contracting – rate negotiation and alignment strategies, contract resolution and escalation of payment discrepancies
Value Based Care Program performance – contract monitoring and analysis, dashboard review with Medical Group and community providers through Frederick Integrated Health Network (FIHN) organization
Maryland Healthcare Specific Responsibilities:
HSCRC Rate Management: Ensure rate orders are optimized to realize the full potential of the approved Global Budget while maintaining compliance with state-mandated policies.
GBR Performance Strategy: Develop strategies to maximize GBR by reducing potentially avoidable utilization and shifting care to lower-cost settings without losing budget value.
Market Shift Oversight: Monitor and manage market shift adjustments to ensure revenue is captured or protected when patient volumes move between facilities in the service area.
Quality & Policy Alignment: Partner with clinical leadership to ensure high performance in HSCRC Quality Programs (e.g., Readmissions, Quality-Based Reimbursement), as these results directly impact the global revenue ceiling.
Capital Policy Planning: Coordinate large-scale project funding through the HSCRC Capital Policy, ensuring new projects receive appropriate rate updates and meet state efficiency standards.
Required Knowledge, Skills and Abilities:
Demonstrated extensive knowledge of third-party and insurance company operating procedures, regulations and billing requirements, and government reimbursement programs.
Excellent command of medical information systems for billing and accounts receivable, spreadsheets, reporting applications, medical terminology, coding and office procedures. Adds value to the organization through proactive analysis of and resolution to potential bottlenecks that may negatively affect the organization’s reimbursement and accounts receivable.
Demonstrated success in yielding significant results in improving patient accounts receivable.
Must possess superior communication skills, demonstrate the ability to work in a team environment, and be able to effectively integrate front and back-end work processes and personnel toward a common goal.
Ability to maintain a high level of confidentiality.
Deep knowledge of healthcare industry trends, CRM/EHR systems, financial forecasting, and change management.
Minimum Education, Training, and Experience Required: • Bachelor’s degree in Accounting, Finance, Business Administration or related field or equivalent combination of education and experience. MBA preferred.
• 10+ years in progressive revenue operations or healthcare RCM roles, with at least 5 years in senior leadership.
• Five to seven years (5-7) years’ experience in Maryland rate setting and reimbursement model management is strongly preferred.
• Experience in oversight of revenue cycle operations, both acute and ambulatory is strongly preferred.
Performance of job does not require patient contact.
Physical Demands:
Sedentary - Light Work - Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting, a certain amount of walking or standing is often necessary.
Reporting Relationship:
Reports to CFO
Caring for you as you care for the CommUNITY Frederick Health offers a comprehensive and affordable benefits package. Health, Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer multiple plans to best meet your and your family's needs. Life insurance, Short-Term Income Replacement and Long-Term Disability are employer paid for eligible employees. Frederick Health offers a robust Paid Time Off program for eligible employees. Our 403B retirement plan helps you save for your retirement and includes an employer match to eligible employees. All employees have access to free financial planning sessions. We also offer an educational assistance program to support your education goals as well as an employer paid Employee Assistance Program.
Pay is based on experience, skills and education. If position is part-time, salary will be pro-rated based on scheduled hours. The pay range may also vary within the stated range based on specialty if applicable. Non-Exempt po sitions may have shift differential and/or Overtime paid, if applicable.
Qualifications Education Required Bachelors or better.
Experience Required 10+ years in progressive revenue operations or healthcare RCM roles, with at least 5 years in senior leadership
Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
#J-18808-Ljbffr