Executive Director Revenue Cycle

Title: Executive Director Revenue Cycle

Location: Fountain Valley, CA

Department: Physician Billing

Status: Fulltime

Shift: Day

Pay Range*: $180,398 - $248,060/annually

Memorial Care is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups—comprising over 200 sites of care and more than 2,000 physicians across Orange and Los Angeles Counties. We are dedicated to increasing access to patient-centric, affordable, and high-quality healthcare. Your contributions are vital to Memorial Care's recognition as a market leader and innovator in value-based and other care models.

We support our employees' professional development, contribution, collaboration, and accountability. Whatever your role and expertise, we are committed to helping you reach your full potential in an environment of respect, innovation, and teamwork.

Position Summary

Lead the strategy and operations of revenue cycle functions for MCMF (Memorial Care Medical Foundation) and Nautilus, including services for Memorial Care Medical Group (MCMG), Memorial Care Specialty Medical (MSMG), and Nautilus independent physicians.

Essential Functions and Responsibilities

• Lead and manage end-to-end revenue cycle strategy and operations, including patient registration, insurance verification, charge capture, coding, billing, claims management, denial resolution, and collections.
• Develop and implement initiatives to improve revenue cycle performance, reduce denials, and enhance cash flow.
• Drive continuous improvement through data analysis, benchmarking, reporting, and adoption of best practices.
• Monitor and manage KPIs such as Days in A/R, Net and Gross collection ratios, denial rate, first-pass resolution, clean claim rate, bad debt rate, cost to collect, patient collections, credit balance resolution days, and patient satisfaction.
• Optimize workflows to minimize cycle times, rework, and expenses, incorporating automation and AI where appropriate, applying Lean Six Sigma principles.
• Ensure timely and accurate reporting of KPIs to stakeholders and clients.
• Lead and develop a high-performing team of directors, managers, supervisors, and staff, fostering a culture of learning, growth, and accountability.
• Ensure compliance with federal, state, and payer regulations, including HIPAA, CMS, and insurance requirements, and oversee coding optimization and compliance.
• Collaborate with IT and clinical operations to optimize EHR and practice management systems for revenue cycle efficiency.
• Partner with finance and accounting teams for accurate financial reporting and forecasting.
• Serve as a liaison with vendors, payers, and regulatory bodies, and coordinate with Nautilus and MCMG teams on contract and operational issues.
• Participate in MCMF’s Executive Management Team meetings and stay informed on billing, reimbursement, legislative, and regulatory changes.

* Placement in the pay range depends on experience and qualifications. Additional compensation may include shift differentials, incentives, and bonuses. Memorial Care offers comprehensive health insurance options and other benefits. For more information, visit our Memorial Care Benefits.

Minimum Requirements

• At least 7 years of progressive leadership in revenue cycle management within a health system or large medical group.
• Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or related field required;
  Master’s degree preferred.