Job Description

Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.

As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge .

Reporting to the Vice President of Practice Revenue Cycle Operations, the Director of Practice Revenue Cycle Operations will work directly with local leadership to support specialty practice partnerships within the growing Optum Specialty Practice (“OSP”) group. This position is responsible for recommending and assisting specialty practices with process improvement, consolidation efforts, implementation of new technologies, transition management, execution of goals, and meeting KPI standards.

OSP partners with specialty physician groups, through Management Service Organizations (“MSOs”) to support their migration into value-based healthcare as part of the OptumCare team. OSP partners to provide practice management and clinical performance support, referral and payer alignment, data analytics, and strategic capital while the practices themselves provide physician leadership, market knowledge and clinical excellence to create market-leading specialty care delivery systems. OSP is responsible for delivering high-value specialty care networks that overlay and integrate with SCA, OptumCare Care Delivery Organizations (CDOs), and other OptumCare partners.

Key Responsibilities:

• Works closely with the practice leadership team to ensure that KPI metrics of Revenue Cycle Operations are achieved and quality standards are met.
• Acts as a strategic business partner with local leadership and operational OSP counterparts to identify RCO performance improvement opportunities.
• Reviews, analyzes and interprets financial data to monitor progress toward established goals.
• Assists with the ongoing management and evaluation of vendor relationships (domestic and offshore).
• Reviews business terms associated with vendor contracts/agreements and coordinates finalization with legal resources.
• Ability to make effective and persuasive presentations on complex topics to management, public groups and or boards of directors.
• Prepares for and presents RCO updates during monthly operational meetings to SCA and practice leadership.
• Works with specialty practices to document core workflows, develop standard operating procedures, and coordinate implementation plans for the roll-out of new processes.
• Assists with the integration of new technologies to ensure smooth transition.
• Develops a positive culture by promoting positivity and collaboration with internal and external team members.
• Strong Communication skills required.

• Undergraduate or graduate degree in business, healthcare, or related field preferred
• 8 years of relevant experience plus 5 years of management experience.
• Experience working with large single or multi-specialty physician groups
• Experience with Cardiovascular practices preferred
• Understanding of the various roles, responsibilities, and technical aspects of the entire revenue cycle, specifically in the healthcare, medical, or ambulatory surgery center industry
• Hands on knowledge of technical dependencies impacting RCO including interfaces, file transfers, electronic claim loops/segments, clearinghouses, etc.
• Proven track record of developing successful relationships and business partnerships with physicians
• Superior knowledge of medical terminology and health insurance billing
• Working knowledge of MS Office Suite including Word, Outlook, Excel, and PowerPoint
• Demonstrate strong communication skills, verbal and written
• Willing to travel 25% and potentially more over the entire national market.

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