Division

Emory Healthcare Inc.

Campus Location

Atlanta, GA, 30345

Campus Location

US-GA-Atlanta

Department

EHI Rev Cycle Administration

Job Type

Regular Full-Time

Job Number

161094

Job Category

Revenue Cycle & Managed Care

Schedule

8a-4:30p

Standard Hours

40 Hours

Hourly Minimum

USD $0.00/Hr.

Hourly Midpoint

USD $0.00/Hr.

Be inspired. Be rewarded. Belong. At Emory Healthcare.

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

• Comprehensive health benefits that start day 1
• Student Loan Repayment Assistance & Reimbursement Programs
• Family-focused benefits
• Wellness incentives
• Ongoing mentorship, development, and leadership programs
• And more

Work Location: Atlanta, GA

• The Vice President of Revenue Optimization & Government Reimbursement provides executive leadership for enterprise revenue integrity, Charge Description Master (CDM) governance, government reimbursement, and revenue optimization strategy across Emory Healthcare
• Reporting to the Chief Revenue Cycle Officer, this role is responsible for the strategic direction, operational performance, and financial outcomes of both Hospital Billing (HB) and Professional Billing (PB) revenue optimization functions, as well as the Government Reimbursement team
• The Vice President oversees Revenue Integrity, CDM, and Government Reimbursement and partners closely with Charge Capture, Finance, Managed Care, Compliance, and clinical leadership to ensure accurate, compliant, and optimized revenue realization across all payers, with specific accountability for governmental reimbursement strategy and regulatory alignment
• This role serves as a key enterprise executive partner driving revenue sustainability, regulatory compliance, and margin improvement through innovation, analytics, and system optimization
• Executive Revenue Optimization Leadership
  • Provide enterprise executive leadership for revenue integrity, charge capture alignment, and revenue optimization strategy across HB and PB
  • Oversee:
    • Revenue Integrity
    • Charge Description Master (CDM)
  • Government Reimbursement
  • Establish enterprise governance structures to ensure alignment with health system financial and operational priorities
  • Identify, quantify, and remediate revenue leakage through analytics, operational redesign, and technology enablement
  • Drive performance improvement initiatives impacting net revenue, compliance, and denial prevention
• Government Reimbursement Oversight
  • Provide executive oversight of Government Reimbursement strategy, including Medicare, Medicaid, and other federal/state reimbursement programs
  • Ensure organizational readiness and compliance with evolving CMS and state regulatory requirements
  • Oversee:
    • Cost report strategy and optimization
    • Disproportionate Share Hospital (DSH) programs
    • Graduate Medical Education (GME) reimbursement
    • Supplemental payment programs
    • Regulatory filing and audit coordination
  • Partner with Finance and Policy leaders to model reimbursement impacts and optimize governmental revenue streams
  • Serve as executive liaison for governmental reimbursement audits, appeals, and regulatory reviews
• Charge Description Master (CDM) Governance
  • Oversee enterprise CDM strategy, maintenance, and governance
  • Ensure compliant and optimized charging aligned with regulatory, payer, and contractual requirements
  • Lead enterprise CDM audits, charge reviews, and remediation initiatives
  • Drive standardization of charging practices across the system
• Documentation & Charge Capture Optimization
  • Partner with clinical, operational, and revenue cycle leaders to improve documentation impacting charge capture and reimbursement
  • Support provider and departmental education related to charging accuracy and compliance
  • Align charge capture workflows with digital and AI-enabled solutions
• Data, Analytics & Enterprise Strategy
  • Leverage advanced analytics to identify performance gaps, reimbursement risk, and optimization opportunities
  • Establish executive KPIs and dashboards for revenue optimization and government reimbursement performance
  • Partner with Digital and IT teams to deploy automation, AI, and system enhancements supporting middle revenue cycle transformation
• Collaboration & Executive Leadership
  • Serve as an enterprise executive partner across Revenue Cycle, Finance, Digital, Compliance, Legal, Managed Care, and Clinical Operations
  • Lead cross-functional initiatives to improve middle revenue cycle performance and governmental reimbursement outcomes
  • Represent Revenue Optimization and Government Reimbursement at executive leadership forums
  • Mentor and develop senior leaders and high-potential talent
• Additional Duties as Assigned
• Work Type: Remote Employee Minimal Travel required

MINIMUM REQUIRED QUALIFICATIONS:

• Education: Bachelor's, Healthcare Administration, Business Administration with a Healthcare or Finance Concentration or equivalent
• Experience: 10+ years of progressive healthcare revenue cycle leadership experience, including executive oversight of revenue integrity and/or government reimbursement functions within a large, complex health system

Knowledge, Skills, and Abilities (Required)

• Deep expertise in revenue integrity, CDM governance, and middle revenue cycle operations
• Executive-level knowledge of Medicare, Medicaid, and governmental reimbursement methodologies
• Experience in large academic health systems utilizing Epic
• Strong understanding of healthcare reimbursement, regulatory compliance, and audit risk
• Proven executive leadership, change management, and strategic planning capabilities

Knowledge, Skills, and Abilities (Preferred)

• Education: Registered Nurse; Coding, Billing, or Revenue Cycle certification; Master's degree preferred
• Experience: Experience leading large-scale financial optimization initiatives and governmental reimbursement strategy yielding multi-million-dollar impact

JOIN OUR TEAM TODAY! Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnet® designated ambulatory practice. We are made up of 11 hospitals-7 Magnet® designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

ACCOMMODATIONS: EHC will provide reasonable accommodation to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Leave and Accommodations.

PHYSICAL REQUIREMENTS: (Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday; (frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environmental conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.

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