Senior Director Enterprise Patient Access and Financial Clearance
$162,988–$268,881 year
Hybrid · Providence, Rhode Island, United States or Massachusetts, United States
Job Summary
Senior-level leadership role overseeing enterprise Patient Access and Financial Clearance across Rhode Island and Massachusetts entities. Owns centralized PAC functions (Pre-registration, Insurance Verification, Authorization, Financial Clearance, Denials Prevention) and hospital-based ADT/registration operations. Drives standardization of policies/workflows, KPI tracking, Epic system optimization (Prelude, Cadence, ADT, Resolute HB/PB), and cross-functional collaboration with IT, Finance, HIM, Coding, Compliance, Payer Contracting, and Operations. Focused on reducing denials, improving clean claims, and delivering a patient-centered, compliant, and efficient access experience across multi-site, multi-state operations. Requires extensive Epic experience, knowledge of payer requirements, and leadership of shared services models in academic health systems.
Required Qualifications
- Bachelor's degree in business, Health Information Management, Finance, Healthcare Administration, or related field
- Minimum 8–10 years of progressive leadership in patient access, revenue cycle, or healthcare operations
- At least 5 years in a senior management role in a large, multi-entity health system
- Epic Proficiency: Prelude, Cadence, ADT, Grand Central, Resolute HB/PB
- Deep understanding of hospital and professional billing workflows and payer requirements
- Experience with denial prevention and KPI improvement
- Knowledge of CMS, HIPAA, No Surprises Act, RI/MA regulations, payer policies
- Preferred: Master’s degree (MBA, MHA) and CHAM/CHFP certification
Desired Qualifications
- Bachelor's degree in business, Health Information Management, Finance, Healthcare Administration, or related field; Minimum 8–10 years of progressive leadership in patient access, revenue cycle, or healthcare operations, with at least 5 years in a senior management role in a large, multi-entity health system.
- Epic Proficiency: Extensive hands-on experience with Epic Prelude, Cadence, ADT, Grand Central, Resolute HB/PB, and associated revenue cycle modules in an enterprise environment.
- Knowledge of CMS, HIPAA, No Surprises Act, state regulations (RI/MA), and payer-specific policies.
- Certification: CHAM, CHFP, or equivalent professional certification (preferred).
- Experience leading centralized Patient Access Center / shared services models in a multi-state, multi-entity academic health system.
- Experience with Epic implementations, go-lives, and system transitions.
- Familiarity with HFMA, MGMA, and NAHAM benchmarking standards.
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