Confidential mandate
Revenue Cycle Improvement Director — Consulting, Hospital Network
Planned Hiring / New
A hospital network commissions a four-month redesign of billing, payer authorisation, denial management and cash controls to reduce leakage without shifting burden onto patients or clinicians.
The mandate
The problem is avoidable revenue leakage and delayed cash across admission, authorisation, coding, discharge and denial processes. Local workarounds have obscured root causes and created inconsistent patient communication.
The assignment delivers a transaction-level leakage baseline, future-state workflows, control matrix, payer-denial playbook, role design, dashboard specification and a validated implementation case.
Milestone one arrives 30 September 2026 with baseline and root causes; milestone two on 31 October with redesigned journeys and controls; milestone three on 30 November with a tested pilot, benefits validation and rollout plan.
The Revenue Cycle Council accepts the work when billed-to-earned revenue reconciles within one percent, the top ten denial causes have owner-tested remedies, pilot turnaround improves fifteen percent, and patient complaint indicators do not deteriorate.
The network provides billing and clinical-system extracts, payer contracts, denial files, write-off approvals, patient complaints and access to three representative hospitals. A finance analyst and clinical-coding lead are assigned full time.
Why this is external work
Hospital teams are occupied with daily throughput and have normalised site-specific workarounds. Independent analysis can follow one episode across clinical, payer and finance boundaries. The specialist capacity is needed for a finite diagnostic and pilot, not as permanent management.
What you will own
- Reconcile charges, earned revenue, receipts, denials, write-offs and refunds for milestone one.
- Trace high-value patient episodes across authorisation, coding, discharge and claim submission.
- Quantify root causes by payer, specialty, hospital and workflow step.
- Design standard controls and patient communications for milestone two.
- Build the top-ten denial prevention and recovery playbook.
- Run a controlled pilot in one hospital with agreed service guardrails.
- Present validated benefits, systems backlog and rollout ownership at milestone three.
Candidate qualifications
- 18–22 years in hospital finance, revenue cycle, payer operations or healthcare transformation.
- Direct redesign experience across billing, coding, authorisation and denials.
- Ability to reconcile clinical episodes with accounting and cash records.
- Evidence of improving revenue without inappropriate billing or patient friction.
- Working knowledge of hospital information, payer and claims workflows.
- Experience running onsite pilots with clinicians and finance teams.
Non-negotiables
- No percentage-of-recovery compensation or payer-intermediation interest.
- Patient and clinical data remain in the network's secure systems.
- Onsite presence across all three pilot hospitals during baseline work.
- Benefits accepted only after CFO reconciliation and patient-service review.
- 49 words maximum. Which hospital revenue-cycle redesign did you deliver, and what reconciliation proved the benefit was real?
- 49 words maximum. How would you identify whether denials originate in clinical, coding, authorisation or payer behaviour?
- 49 words maximum. Which extracts and contracts must be available during your first ten working days?
This mandate is confidential. The client is named only under a mutual NDA, and your own record is never listed, sold or shown to a company under your name until you release it for this specific mandate.