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2 days
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$32.45/hr - $49.22/hr (Estimated)
<p>Site: The Brigham and Women's Hospital, Inc.</p> <p>Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.</p> <p>Job Summary</p> <p>Reporting to the VP of Radiation Oncology, the Director of Enterprise Radiation Oncology Revenue is a critical leadership role responsible for setting the strategic direction and providing integrated operational oversight of revenue cycle and prior authorization functions across the Mass General Brigham (MGB) Radiation Oncology enterprise. As MGB continues to advance enterprise integration, this leader will drive the transition from site-specific workflows to a highly efficient, standardized operating model. The ideal candidate brings deep expertise in radiation oncology coding, billing, and payer requirements, including complex modalities such as proton therapy, SBRT, and HDR brachytherapy, and a demonstrated track record of leading large-scale change management and transformation initiatives.</p> <p>Qualifications</p> <p>Key Responsibilities</p> <p>Strategic Integration & Enterprise Leadership</p> <ul> <li>Lead the consolidation and integration of radiation oncology billing and authorization teams across all MGB sites into a unified, high-performing enterprise department. </li><li>Develop, implement, and maintain standardized Standard Operating Procedures (SOPs) for coding, charge capture, and prior authorizations across the network to ensure consistency and maximize efficiency. </li><li>Partner closely with the VP of Enterprise Radiation Oncology, clinical leadership, physics leadership, and hospital finance teams to align revenue cycle operations with clinical and strategic goals. </li><li>Act as the primary liaison between Radiation Oncology and central MGB Revenue Cycle/Managed Care departments. </li></ul> <p>Insurance Authorization & Financial Clearance</p> <ul> <li>Oversee the prior authorization team, ensuring timely and accurate financial clearance for all radiation oncology treatments to prevent delays in patient care. </li><li>Develop specialized workflows and payer-advocacy strategies for high-scrutiny and advanced modalities, particularly Proton Therapy, ensuring rigorous peer-to-peer support and appeals management. </li><li>Monitor payer policy changes and proactively educate clinical and administrative staff on shifting authorization requirements. </li></ul> <p>Revenue Cycle Management & Optimization</p> <ul> <li>Direct the daily operations of charge capture, coding, and billing for both technical and professional fee billing across the enterprise. </li><li>Analyze claim denials and underpayments; design and execute targeted workflows to reduce denial rates and accelerate accounts receivable (A/R) turnaround times. </li><li>Perform regular revenue integrity audits to ensure all clinical services are accurately captured and billed compliantly. </li><li>Leverage the Epic EMR system and ARIA/Mosaiq interfaces to automate workflows and improve charge capture accuracy. </li></ul> <p>Team Management & Development</p> <ul> <li>Recruit, train, mentor, and evaluate a large, distributed team of authorization specialists and billing coordinators. </li><li>Establish clear Key Performance Indicators (KPIs) and productivity metrics for the team; conduct regular performance reviews and provide ongoing professional development. </li><li>Foster a collaborative, patient-centric culture that emphasizes continuous improvement and operational excellence. </li></ul> <p>Compliance & Quality Assurance</p> <ul> <li>Ensure all billing and coding practices strictly adhere to CMS regulations, commercial payer guidelines, and internal MGB compliance standards. </li><li>Maintain comprehensive knowledge of CPT, ICD-10, and HCPCS codes specific to radiation oncology. </li></ul> <p>Qualifications</p> <p>Education & Experience</p> <ul> <li>Education: Bachelor's degree in Healthcare Administration, Business, Finance, or a related field required. Master's degree (MHA, MBA) highly preferred. </li><li>Experience: Minimum of 7-10 years of progressive leadership experience in healthcare revenue cycle management, with a minimum of 5 years specifically dedicated to Radiation Oncology. </li><li>Integration Experience: Proven experience successfully integrating operations or leading change management initiatives across a complex, multi-site healthcare system or academic medical center. </li></ul> <p>Certifications</p> <ul> <li>Radiation Oncology Certified Coder (ROCC) certification is strongly preferred. </li><li>Additional certifications such as CPC, RHIA, or RHIT are advantageous. </li></ul> <p>Skills & Competencies</p> <ul> <li>Subject matter expert in radiation oncology modalities (External Beam, IMRT, SBRT, SRS, Proton Therapy, Brachytherapy) and their associated revenue cycles. </li><li>Advanced proficiency with electronic medical records (Epic strongly preferred) and oncology information systems (ARIA/Mosaiq). </li><li>Exceptional analytical skills with the ability to translate complex data into actionable operational strategies. </li><li>Strong executive presence, with the ability to communicate effectively with physicians, senior administration, and external payer representatives. </li></ul> <p>Additional Job Details (if applicable)</p> <p>Remote Type</p> <p>Remote</p> <p>Work Location</p> <p>45 Francis Street</p> <p>Scheduled Weekly Hours</p> <p>40</p> <p>Employee Type</p> <p>Regular</p> <p>Work Shift</p> <p>Day (United States of America)</p> <p>Pay Range</p> <p>$124,342.40 - $180,897.60/Annual</p> <p>Grade</p> <p>9</p> <p>At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.</p> <p>EEO Statement:</p> <p>2200 The Brigham and Women's Hospital, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.</p> <p>Mass General Brigham Competency Framework</p> <p>At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.</p>
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