Vice President of Business Office Operations

The Vice President of Business Office Operations is responsible for overseeing and strengthening financial operations across the organization's skilled nursing facilities. This role provides leadership, direction, training, and accountability to six Business Office Managers (BOMs) and serves as the primary operational resource for facility-level financial operations.

The VP ensures that all financial components of the admissions process, billing, accounts receivable, collections, and resident financial matters are addressed accurately and timely. The position works directly with facility leadership, BOMs, Admissions, Revenue Cycle, and Finance to identify issues, drive resolution, improve cash collections, and establish consistent financial processes across all facilities. This is a hands-on leadership role requiring regular on-site facility visits, BOM training, coaching, operational reviews, and direct facility support.

• Provide direct leadership, oversight, coaching, and support to six Business Office Managers.
• Establish clear expectations, performance standards, deadlines, and accountability measures for BOMs.
• Conduct regular BOM meetings to review financial performance, A/R, collections, admissions, outstanding issues, and facility-specific priorities.
• Maintain a regular on-site presence at facilities to provide hands-on BOM training, coaching, process review, and problem resolution.
• Conduct periodic on-site business office reviews to assess processes, identify gaps, and ensure established procedures are followed.
• Assist with onboarding and training of newly hired BOMs, evaluating performance and establishing corrective action plans when necessary.
• Serve as the final escalation point for complex facility-level financial, billing, admissions, and A/R matters.

• Take full ownership of driving timely cash collections across all assigned facilities in alignment with corporate objectives.
• Work directly with the Revenue Director to ensure timely and effective collections across private pay, Medicaid, Medicare, and managed care.
• Monitor facility cash collections, review aging A/R regularly, and establish aggressive action plans for accounts that are stagnant.
• Identify trends and systematic barriers negatively impacting collections and implement operational corrective action plans.

• Front-End Alignment: Partner closely with the VP of Strategic Initiatives and Admissions Directors to optimize the front-end admissions workflow, ensuring rigorous financial verification and authorization protocols are met before or immediately following admission.
• Process Training: Provide joint training and standardized resources to Admissions Directors and Business Office teams on critical front-end financial requirements and risk-mitigation strategies.
• Trend Identification: Monitor new admissions to ensure pre-admission financial issues are caught early, resolving recurring front-end deficiencies through collaborative process design.

• Monthly CFO Reporting: Compile, analyze, and present comprehensive monthly A/R reporting packages and KPI analytical summaries directly to the Chief Financial Officer (CFO).
• KPI Management: Actively track, optimize, and report on key performance indicators including private-pay collections, overall cash collections, A/R aging thresholds, Medicaid-pending progression, denials, rejections, unapplied cash, and guardianship accounts.
• Executive Insights: Evaluate performance variations across all six facilities, translating data metrics into operational trends and actionable executive insights for senior leadership intervention.
• Provide oversight and operational support for Medicaid-pending residents to ensure applications progress timely and missing documentation is resolved.
• Work closely with facility leadership, families, and legal representatives on residents requiring guardianship or external financial intervention to prevent payment delays.
• Partner with internal and external legal resources to move unresolved guardianship or uncooperative responsible-party cases forward.

• Partner closely with the CFO and Finance leadership to align business office workflows with organizational cash flow objectives.
• Strategic
  
  Collaboration:
  
  Partner with the VP of Strategic Initiatives on company-wide front-end operational…