Director, Revenue Operations - Health Insurance Contracts

ESSENTIAL FUNCTIONS: - Designs and continuously improves revenue-supporting operational strategy plans, workflows and controls to promote consistent, accurate, and timely reimbursement across services. - Establishes revenue integrity and performance monitoring practices, integrating pre-audit oversight, outcome tracking, and trend analysis to support accurate billing, early issue identification, and reliable revenue forecasting. - Leads structured approaches to denial management, ensuring complex or high-impact denials are escalated appropriately, resolved efficiently, and used to strengthen future operational performance. - Creates and maintains feedback loops between revenue outcomes and operational practice, translating insights into process enhancements, education, and preventive improvements. - Ensures alignment and coordination across revenue-impacting functions, supporting shared accountability, clear communication, and seamless handoffs among clinical, operational, and administrative teams. - Leverages revenue data, reporting, and systems to enhance visibility, inform decision-making, and support scalable operations as services and volumes expand - Partners with payer organizations and internal leaders to support contract performance and reimbursement optimization, including collaboration related to fee schedules, referral pathways, and payer requirements. - Provides revenue and operational input into payer relationships, new contracts, and funding opportunities, supporting sustainable rates, service viability, and long-term growth. - Partners with organizational leaders to support new service development, pilot programs, and funding initiatives, providing revenue and operational insight to assess feasibility, sustainability, and reimbursement readiness. - Supports revenue readiness for new programs and service lines, ensuring processes, systems, and expectations are established to enable successful launch and long-term financial performance. - Provides leadership and development for revenue operations staff and leaders, fostering accountability, collaboration, and continuous improvement in support of organizational goals. - Maintains deep awareness of industry standards and emerging best practices in healthcare administration, translating external insights into practical application to support Easterseals' future needs. - Performs other duties as assigned.

EDUCATION: - Bachelor's degree in healthcare administration, business administration, or closely related field. - Professional certifications in healthcare finance, revenue operations, or revenue cycle management preferred. EXPERIENCE: - Minimum of 12 years including (8) years of progressive experience in healthcare operations, revenue operations, or related healthcare leadership roles. - Demonstrated experience leading complex, cross-functional initiatives within a healthcare or behavioral health setting, including partnership with clinical, operational, financial, and administrative leaders. - Proven leadership experience, including direct supervision of staff and/or managers, with responsibility for setting performance expectations, driving improvement, and supporting team development. - Experience working with payer organizations required, including collaboration related to reimbursement structures, fee schedules, referral pathways, contract performance, or payer requirements. - Experience supporting organizational growth initiatives, such as new service development, program launches, alternative funding models, or expansion into new service lines preferred. - Experience operating in multi-site, growing, or complex healthcare environments preferred.

EXEPECTED NUMBER OF DIRECT REPORTS: Up to seven (7) direct reports. KNOWLEDGE, SKILLS, ABILITIES: - Demonstrated ability to build and maintain effective professional relationships and work collaboratively across departments, including with clinical, operational, financial, and external partners. - Demonstrated leadership skills, including change management, flexibility, initiative, and the ability to guide teams, influence outcomes in complex environments, and supervise staff effectively. - Strong analytical and problem-solving skills, with the ability to evaluate information, identify trends or risks, and apply sound judgment to develop sustainable operational solutions. - Ability to effectively develop, lead, and manage staff and operational initiatives or programs that strategically support ESSC organizational priorities, business needs, financial sustainability, and quality service delivery to consumers. - Excellent written and verbal communication skills, including the ability to clearly convey information to diverse audiences, conduct presentations, and advocate effectively on behalf of programs or initiatives. - Ability to demonstrate good judgment, exercise discretion, and maintain a high level of confidentiality in handling sensitive situations and documentation. - Demonstrated organizational and time management skills, including the ability to manage multiple priorities, respond to varying demands, and meet deadlines. - Strong interpersonal skills, with the ability to work effectively with culturally diverse, low-income populations and in multicultural environments. - Demonstrated computer proficiency, including Microsoft Office applications (Outlook, Word, Excel, Teams) and related software applications. - Strong interest and commitment to working in multi-cultural settings. - Able to obtain and maintain a criminal record/fingerprint clearance from the Department of Justice and Federal Bureau of Investigation per Easterseals Southern California and/or program requirements. - Ability to travel throughout Southern California with reliable transportation, maintain driving record in compliance with Transportation Safety Standards; must have and maintain proper auto insurance and vehicle registration. - Ability to pass post-offer medical examination. - Must pass all drug testing required by ESSC.

PHYSICAL REQUIREMENTS IN ACCORDANCE WITH ADA: - Carrying/Lifting: Occasional / 0-10 lbs. - Standing: Occasional / Up to 3 hours per day. - Sitting: Constant / Up to 8 hours per day. - Walking: Occasional / Up to 3 hours per day. - Travel : Up to 25 % of time. - Repetitive Motion/Activity: Keyboard activity, telephone use, writing. - Visual Acuity: Ability to view computer monitor and read newsprint. - Environmental Exposure: Regularly duties do or do not involve exposure to blood, body fluids, or tissues; but employment may require performing unplanned tasks that do involve such exposure.