Chief Medical Officer Revenue Cycle
UCHealth · United States
FULL TIMEfull-time
Job Description
Description The Opportunity Chief Medical Officer, Revenue Cycle The Chief Medical Officer, Revenue Cycle, serves as the key senior physician executive supporting revenue cycle functions and partners with the System CMO and PEC (Physician Executive Counsel) to advance physician and APP engagement in utilization management, denials management, clinical documentation integrity, care continuum integration, and related activities across inpatient, ambulatory, and post-acute settings. The Chief Medical Officer, Revenue Cycle serves as the physician executive sponsor and medical director for those areas, providing clinical leadership, advocacy, consultation, and physician engagement. This responsibility includes Coding, Health Information Management (HIM), Denials Management, and other mid-revenue cycle functions, helping ensure operational decisions are informed by clinical expertise and aligned with organizational quality, compliance, documentation, and financial objectives. Reporting Relationships Reports to: UCHealth System Chief Medical Officer, with a dotted-line relationship to the Vice President, Revenue Cycle. Directed accountability: Physician Advisor Program; Clinical Documentation Integrity and documentation education; Utilization Management; denial and appeal support; and Care Continuum Integration. Matrixed accountability: Denials Management; Health Information Management; Coding; and Revenue Integrity. Scope of Responsibility Directed Accountability: Physician Advisor Program
- CDI and Documentation Education
- Utilization Management
- Denial and Appeal support
- Care Continuum Integration
- HIM
- Coding
- Revenue Integrity
- Call center for transfers, direct admits and consultations
- Utilization Management
- Peer review
- Clinical Documentation Integrity
- Capacity Management
- Clinical validation and medical necessity
- Denials, audits
- Leadership of AI-enabled physician advising programs
- Chair of system CDI steering committee
- Escalation for coding and CDI adjudication
- Medical Direction for Coding functions
- Enterprise-wide hospital capacity management and throughput
- Oversight of centralized access and intake functions (e.g., DocLine)
- Oversight of care management, social work, and related functions
- Oversight of post-acute care strategy and performance
- Advise contract negotiations and reimbursement strategy discussions
- Provide clinical input regarding payer policies
- Evaluate financial and clinical implications of proposed contract changes.
- Closed-loop feedback to frontline clinicians, quality, revenue cycle, and contracting
- HCC accuracy
- Access and throughput in relation to recent hospitalizations and avoidable utilization
- ED utilization, post-acute utilization, and readmissions
- Faculty, employed, and independent physician and APP alignment
- Member of PEC
- MD or DO; board certification and Colorado medical licensure required
- At least 10 years of physician leadership experience
- Leadership position in a national or regional physician organization preferred.
- Experience in financial management and an understanding of healthcare economics.
- Understands all aspects of clinical quality: optimal, efficient, patient-driven processes of care; reliable, safe and effective care; and optimal health-related outcomes for individuals and populations.
- Experience that demonstrates knowledge of process improvement infrastructure including how to implement decision tools, clinical protocols and guidelines and care management outcome assessments.
- Providing strategic direction for the hospital and health system on issues related to clinical program development.
- Performance bonus: UCHealth offers an Annual Performance Bonus to recognize employee contributions to our success in quality, patient experience, organizational growth, and financial goals.
- Performance-based pay increase: The Annual Merit Pay Increase recognizes work performance that meets or consistently exceeds performance standards documented through UCHealth's established evaluation process and accounts for increased experience, skills and cost of living.
- Market reviews: All UCHealth positions are reviewed annually to ensure UCHealth base pay aligns with market standards. Base pay rates are adjusted as needed to stay market competitive.
- Medical, dental and vision coverage.
- Access to 24/7 mental health and well-being support for employees and dependents.
- Discounted gym memberships and fitness resources.
- Free Care.com membership.
- Voluntary benefits such as accident insurance, critical illness insurance, group legal plan, identity theft protection, pet insurance, auto and home insurance, and employee discount programs.
- Time away from work: Paid time off (PTO), paid family and medical leave (inclusive of Colorado FAMLI), leaves of absence.
- Employer-provided basic life and accidental death and dismemberment coverage with buy-up coverage options.
- Employer-provided short-term disability and long-term disability.
- 403(b) plan with employer matching contribution.
- Additional 457(b) plan may be available.
- Flexible spending accounts for health care and dependent day care; health savings account available when enrolled in high-deductible (HD) medical plan.
- UCHealth provides access to academic degrees and certificate programs to promote professional and personal growth.
- Up to 100% of tuition, books and fees paid for by UCHealth for specific educational degrees.
- Other programs may qualify for up to $10,000/year pre-paid by UCHealth or up to $5,250/year in the form of tuition reimbursement.
- Access to LinkedIn Learning, which offers thousands of virtual courses and seminars, and internal professional development opportunities.
- Employees have access to free assistance navigating the Public Service Loan Forgiveness program and submitting their federal student loans for forgiveness.
Details
| Company | UCHealth |
| Location | United States |
| Type | FULL TIME |
| Niche | general |
| Experience | full-time |