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Associate VP Revenue Integrity

Farmington, CT

Posted: 08/20/2018 Employment Type: Retained Industry: Executive Level Job Number: 5839

J. Morrissey & Company has been retained for the executive search for the Associate Vice President, Revenue Integrity reporting to the Chief Clinical Revenue Cycle Officer at an area academic health center.  The AVP Revenue Integrity directs and manages all administrative functions that contribute to the capture of patient service revenue. Working collaboratively with operational, functional and clinical areas, the AVP, Revenue Integrity is responsible for performing duties either personally, through the team members or in collaboration with other support areas. This position will also help to ensure that the correct reimbursement is gained from various third party payers performing charge review, chart reviews, audits, and clinical / financial appeals and providing education and guidance to practitioners and other team members

 

PRIMARY RESPONSIBILITIES:
  • Responsible for coordinating external regulatory reporting such as OHCA, Medicare, Medicaid, RAC and other agency reporting
  • Improve systems net revenues, revenue compliance and cash collections by optimizing the system wide revenue cycle. Lead the team to ensure revenue, billing, charging and coding compliance through education of hospital personnel on current and changing regulations.
    • Responsible for the integrity and management of the EPIC software as it related to the revenue cycle (i.e. charge master, work queue management, charge routing, edit development and assignment)
    • Represents hospital and physician finance areas and works collaboratively with departments and practice operations throughout to develop and implement procedures which represent mutual concerns. Interact with practices and departments to resolve, including but not limited to, charges, lag times, incorrect coding & third party payers compliance.
    • Motivate, trouble shoot, automate & educate cross-department teams' performance towards excellence and optimization in charge capture methodologies, interface reconciliation and audit techniques.
    • Perform charge capture audits and identify root causes of charging practices and deficiencies to effectively address changes needed.

REQUIRED MAJOR QUALIFICATIONS:
  • Bachelor' s degree required in Finance, Accounting, or related Health Care Business discipline, Master' s Degree preferred.
    • Minimum of ten (10)] years revenue related management experience in a hospital environment.
    • Excellent managerial, decision-making, business intelligence, decision support, analytical, planning, prioritization, problem resolution and leadership skills.
    • EPIC experience with implementation and/or revenue stabilization and capture preferred
    • Applicable EPIC certification required within one year of start date

Donna McCarty, CPC
Senior Vice President & CAO

Donna R. McCarty, CPC has over 30 years of experience in the healthcare industry within Connecticut and nationally. Donna has been associated with area hospitals, a health maintenance organization and a national home infusion therapy company.  In these settings, she had the opportunity to be involved in every facet of healthcare, primarily in financial and administrative capacities.

As Senior Vice President & CAO, Donna performs executive searches for leadership roles in healthcare and non-profit organizations. She is also responsible for compliance, contracting, education, public relations, and on-boarding of new employees at J. Morrissey.

Donna’s community involvement includes a longstanding relationship with Prevent Blindness Connecticut.  She has served two terms as board chair, was the 1998 recipient of the Robert and Joyce Polk Award for distinguished service, and the 2001 recipient of the Cincinatus Award for outstanding service and dedication.  She was also the past president and founder of the Greater Hartford Chapter of the Quinnipiac University Alumni Association and was a member of the Quinnipiac University National Alumni Board of Governors for 18 years.  Donna has also served as past president of the Connecticut Women in Health Care Management, served on the UCONN Health Care Management Advisory Board for the university’s undergraduate and graduate health care programs, and The Hartford Courant CareerbuilderRx Advisory Board. Most recently, she was co-chair for Relay For Life in Plainville, CT in 2008-2010. Donna was a founder and president of Women Executives in Healthcare until 2016.

Donna is a 1990 cum laude graduate of Quinnipiac University with a Bachelor of Science degree in Health Management. 

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