AVP Financial Advocacy

Description

Calling All Revenue Cycle Leadership Professionals With A Strong Financial Advocacy along with State and Federal Regulatory Compliance Background.

Do you excel in navigating complex regulatory landscapes and driving transformational change within the Revenue Cycle? If so, then we have the perfect opportunity for you to lead our enterprise-wide Financial Advocacy team!

The Role:

Providence is seeking an enterprise Associate Vice President of Financial Advocacy. In this role, you will have focused accountability on regulatory compliance across the system. In this hybrid role, you will assume a pivotal role encompassing legal coordination, regulatory compliance, strategic decision-making, and leadership. This includes collaborating with key stakeholders across Providence, developing and executing plans for financial assistance, financial counseling and health equity;

leading, contributing to, and partnering with others on strategic efforts; ensuring a compliant and streamlined operational experience for business and patient constituent groups. The AVP will lead and participate in innovation and automation for caregivers  workflow and patient experience. The AVP is accountable for the enterprise-level state and federal regulatory compliance, policies, and procedures, as well as the efficiency and effectiveness of Financial Advocacy Programs and the Medicaid submission process for 51 Providence and Affiliate hospitals, over 1,000 physician practices, and services.

The Providence financial counseling team is insourced, processing nearly 200,000 financial assistance applications annually, resulting in $434M in charity care. About 44,000 Medicaid applications are processed each year with a revenue value of $34M.

The AVP is responsible for leading significant changes across the health system, including collaborating with key vendors concerning financial assistance screening, Federal Poverty Level scoring, and the supporting processes. These system changes have considerable regulatory, compliance, legal, and financial impacts into the tens of millions of dollars.

• Oversee uninsured and charity internal and external audits, acting as the subject matter expert for IRS audits concerning 501(r) requirements.
• Develop and maintain a high-performance team by ensuring staffing levels meet budget, all staff are fully trained, certified, and empowered to achieve performance and quality targets, developing career ladders as appropriate, ensuring individual and departmental compliance with all applicable laws and regulations as well as revenue cycle and Providence policies and procedures.
• Responsible for resolving escalated issues, including CMS, other regulatory bodies, legal, clinical, or patient experience matters.
• Oversee departmental budgets within leadership scope, including participation in budget development, approval responsibility, and ongoing monitoring for productivity and cost compliance.
• Ensure the development of standard educational materials to meet state and federal requirements. Responsible for developing System and state Charity Care/Financial Assistance policies, procedures, and process coordination with revenue cycle, finance, reimbursement, legal counsel, and other stakeholders as needed.
• The AVP leads the annual review of AGB calculations, updates charity policies, plain language summaries, and AGB definitions, updates hospital information systems, and posts charity policies per state regulations. The AVP will also participate in reviewing uninsured discounts with Corporate Reimbursement and Finance.
• Responsible for developing, coordinating, facilitating, administering, and improving internal and external communication programs and initiatives involving topics such as patient registration, financial assistance, billing, as well as those impacting reputation management, compliance, and the supporting culture.

Based in our dynamic setting, you will partner with key stakeholders across the health system to develop and execute plans for financial assistance and health equity. Your leadership will be instrumental in driving innovation, streamlining operations, and enhancing the overall experience for both business and patient constituent groups.

What You ll Do:

• Set strategy and standards for Financial Assistance and Financial Advocacy programs across all Providence ministries.
• Lead proactive internal auditing to ensure adherence to all federal and state regulations, including IRS 501(r) compliance.

• Collaborate closely with Providence Legal and outside counsel to maintain policy compliance and interpret new or draft regulations.
• Act as an internal and external Subject Matter Expert (SME) on complex, high-risk regulatory matters that impact reputational risk.

• Oversee Patient Financial Counseling functions, including the in sourcing of the Medicaid eligibility program and vendor strategy.
• Set strategic and performance goals for the departments, monitor results, and…