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Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Reporting to the VP of Revenue Cycle for the Northern Light Health (NLH) segment of Optum, this position is responsible for providing leadership for all activities related to the management of NLH’s Patient Financial Services (PFS) function. The Director of Patient Financial Services sets the strategic direction for all of NLH’s hospitals, affiliates, physician services and ancillary services for the Patient Financial Services function within the Enterprise Revenue Cycle. The Director of Patient Financial Services is responsible for providing direction and leadership to achieve ongoing operational quality, productivity and efficiency in the Patient Financial Services department, both with the hospitals and physician practices. The Director is responsible for planning, directing and overseeing the performance of the functional areas that report to this position including Claims Processing, Accounts Receivable Management, Payment Posting and Reconciliation, Denials and Underpayment Management, Credit Management, Self-Pay and AR Collections. The role serves as the leader of the Patient Financial Services Department in support of NLH to internal and external organizations, including government agencies, payer organizations and external auditors.

If you are located in the state of Maine, you will have the flexibility to work remotely*, as well as work in the office as you take on some tough challenges.

Primary Responsibilities:

• Setting the strategic direction for the Patient Financial Services, Revenue Cycle function

• Participate on the revenue cycle leadership team overseeing key operational and financial decisions pertaining to the revenue cycle

• Develop, implement, and manage efficient and effective operational policies, processes and best practices within patient financial service (PFS) functions of the revenue cycle which include claims processing, payment posting/credit balance management, third-party follow-up and patient A/R management, adjustment and denial and underpayment processing, managed care compliance, contract management, and other support services

• Implement enterprise-wide projects, as assigned, for realizing process improvement opportunities within patient financial services

• Participate in various IT-related steering committees for information technology changes which affect the patient financial services area and lead project groups as assigned

• Develop and enforce all PFS corporate policies including; account adjustments and write-offs, and collection efforts in collaboration with the VP of Revenue Cycle

• Produce various financial reports/dashboards, including but not limited to month-end financial reporting, receivables levels (days in AR and aging), and any long-range strategic plans for the department

• Set annual goals for patient financial services key performance indicators and report departmental performance around goals and national benchmarks to NLH’s revenue cycle stakeholders

• Routinely conduct payer trend analysis to ensure optimal reimbursement, identify issues, and communicate findings to NLH’s revenue cycle stakeholders

• Ensure compliance with federal and state laws specifically pertaining to patient financial services by analyzing internal policies and implementing appropriate changes

• Oversee and review PFS external audits to prevent internal control weaknesses and to ensure an independent and objective evaluation of the operation

• Assist in evaluating purchases, contracts and services provided by external vendors to ensure best pricing and effective results (collection agencies, claims/statement vendors, reference tools, software tools, etc.)

• Administers expense budget for department

• Presents departmental budget recommendations to VP of Revenue Cycle for approval

• Monitors budget performance and variance explanations

• Optimizes vendor relationships as necessary

• Evaluates current and new technology solutions

• Approves account adjustments, refund requests, and bad debt placements for accounts over specified threshold; forwards all adjustments requests greater specified threshold to VP of Revenue Cycle for approval

• Reviews and approves policies and procedures for the PFS revenue cycle department for the hospitals as well as the related policies and procedures for the physician practices

• Directs activities of staff managers that oversee all aspects of Patient Financial Services

• Provides leadership to direct reports and develops them into strategic thinkers and leaders across the organization

• Provides strategic vision and direction to effectively manage industry shifts, regulatory changes, and rising cost pressures relating to PFS revenue cycle functions

• Evaluates, monitors and assists in developing the priorities and progress of the Revenue Cycle Department

• Provides senior leadership with information regarding receivable and/or departmental performance

• Leads and coordinates ongoing staff evaluation, retention, training and management of policies and procedures

• Manages and oversees staff performance through performance planning, coaching and performance appraisals

• Oversees and ensures two-way communication with PFS staff and Revenue Cycle and hospital/physician leadership

• Develops, implements, and manages efficient and effective operational policies, processes and performance monitoring across all functions of the Revenue Cycle Department

• Ensures Patient Financial Services staff comply with established policies, processes, and quality assurance programs

• Routinely coordinates payor trend analysis to ensure optimal processing and reimbursement, identify issues, communicate findings to Revenue Cycle stakeholders, define

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 8+ years of experience in Patient Financial Services, or directly / indirectly supporting Patient Financial Services in a relatable field

• 5+ years of experience with Excel at a high proficiency range

• 3+ years of experience in analyzing trends with Revenue Cycle and communicating resolutions

• Experience with presenting RCM data to leadership

• Experience creating PowerPoint presentations and presenting to Senior Leaders including C-suite

• Experience working in a fast pace / high stress environment

• Local to Maine

Preferred Qualifications:

• Working knowledge of all functional areas of the revenue cycle

• Proven ability to maintain and exhibit a current knowledge of profession, revenue cycle, regulatory issues and participates in continuing education

• Proven ability to handle difficult and stressful situations with professional composure

• Proven ability to influence others' actions and decisions without express authority

• Proven ability to research, define, effectively communicate, analyze and problem solve trends within the Revenue Cycle for resolution

• Proven ability to understand the changing needs of the Revenue Cycle and utilize technological solutions to improve processes and systems

• Proven high-quality analytical, problem-solving skills and ability to work independently

• Proven exceptional interpersonal and communication skills

• Proven ability to work in an environment of ever-changing priorities

• Proven ability to effectively multi-task and meet deadlines

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.