Project Management Director develops and directs project management operations and strategic planning to meet organizational goals. Provides overall strategic governance for projects by establishing standards, processes, and tools used for effective project delivery. Being a Project Management Director establishes methodologies to set productivity and quality targets and to assess results for all projects. Responds to escalated project issues that may impede project delivery and coordinates solutions. Additionally, Project Management Director monitors and analyzes project metrics to identify weaknesses or problems and to propose operational improvements and cost savings for future projects. Requires a bachelor's degree. May require a project management certification. Typically reports to top management. The Project Management Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Project Management Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Under the general supervision of the Chief Revenue Officer, providing strategic leadership and operational
oversight of denials across the entire healthcare system. This role involves developing and implementing
efficient processes to limit and prevent denials. This will include tracking and trending denials through KPIs to
recover losses to denials. It also includes a project management aspect that will lead projects for revenue
cycle. This position plays a crucial role in planning, executing, and overseeing various revenue cycle projects
within the organization. They are responsible for ensuring that projects are completed on time, within scope,
and within budget while meeting quality standards and stakeholder expectations. They will leads cross-
functional teams, communicates project objectives, monitors progress, and mitigates risks to ensure
successful project outcomes.
1. Develop and implement a strategic vision for denials management services aligned with the organization's goals and objectives.
2. Collaborate with executive leadership to integrate denial prevention initiatives into the overall healthcare system strategy.
3. Provide leadership and direction to the denials management team, including managers, analysts, and specialists, fostering a culture of collaboration, accountability, and continuous improvement.
4. Establish and maintain denials management policies, procedures, and workflows aligned with industry best practices and regulatory requirements.
5. Lead efforts to identify root causes of denials, analyze trends, and implement targeted interventions to address systemic issues impacting revenue cycle performance.
6. Oversee the appeals process for denied claims, ensuring timely and accurate submission of appeals and compliance with payer requirements.
7. Develop and implement metrics and reporting mechanisms to monitor denials rates, appeal outcomes,revenue recovery efforts, and key performance indicators.
8. Recruit, train, mentor, and evaluate denials management staff to ensure a high-performing team capable of meeting organizational objectives.
9. Collaborate with revenue cycle teams, clinical departments, IT, finance, compliance, and payer relations to streamline processes, resolve denials, and optimize reimbursement.
10. Evaluate, select, and implement denials management software and technology solutions to automate workflows, improve productivity, and enhance reporting capabilities.
11. Stay abreast of regulatory changes, payer policies, and industry trends affecting denials management and ensure compliance with applicable regulations and standards.
12. Develop comprehensive project plans, including scope, goals, deliverables, timelines, resources, and budget allocation specific to Revenue Cycle.
13. Identify project stakeholders, establish communication channels, and manage relationships to ensure alignment of expectations and project success.
14. Lead cross-functional project teams, assign tasks, provide direction, and motivate team members to achieve project objectives.
15. Monitor project expenditures, track budget variances, and implement cost-control measures to ensure projects remain within budget.
16. Establish quality standards, conduct regular inspections, and implement corrective actions to ensure deliverables meet quality requirements.
17. Facilitate regular project meetings, provide status updates, and communicate project progress, issues, and resolutions to stakeholders.
18. Evaluate and manage changes to project scope, schedule, and budget, ensuring proper documentation and stakeholder buy-in.
19. Coordinate project closure activities, conduct post-project reviews, document lessons learned, and identify opportunities for process improvement.
Minimum Education
Bachelor's degree in healthcare administration, business administration, or a related field; Master's degree preferred or equivalent experience. Several years of progressive leadership experience in patient access, revenue cycle management, or related healthcare administration roles. Strong understanding of healthcare regulations and compliance requirements. Excellent communication, interpersonal, and leadership skills. Demonstrated ability to drive process improvement and optimize operational efficiency.
Minimum Work Experience
Demonstrated skills in the areas of negotiation, communication (verbal and written), conflict, creative problem solving, and critical thinking.
Knowledge of healthcare financing, community and organizational resources, and data analysis.
Knowledge of denials management.
Experience with managed care preferred.
Excellent verbal and written communication skills required.
Demonstrates flexibility via an ability to adapt to changing priorities and regulations.
Basic computer skills required.
Required Licenses/Certifications
HFMA or PMP certifications preferred.
Required Skills,Knowledge, and Abilities
Understanding of best practice for patient access, insurance eligibility, customer service, authorizations, scheduling, and financial counseling.
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