Reliant Care Management, LLC
Chief Revenue Officer (CRO)
Reliant Care Management, LLC, Saint Louis, Missouri, United States, 63146
Chief Revenue Officer
About Us
We are seeking a strategic leader with genuine empathy and a patient-centered approach to join our skilled nursing and long-term care organization. Our ideal candidate combines compassionate leadership with exceptional business acumen to advance both our financial performance and our mission of providing quality care to our residents. We value work ethic, integrity, and competence as the pillars of successful employment.
Position Overview We are currently seeking a
Chief Revenue Officer (CRO)
to lead our revenue generation strategy and optimize financial performance across our skilled nursing facilities and long-term care operations.
Job Responsibilities and Duties
Develop and execute comprehensive revenue strategies to drive census growth, payor mix optimization, and financial performance across all skilled nursing and long-term care service lines.
Lead contract negotiations with Medicare, Medicaid, Managed Care Organizations (MCOs), Medicare Advantage plans, and commercial payers to secure favorable reimbursement rates and terms.
Oversee skilled nursing facility (SNF) prospective payment system (PPS) management, including PDPM (Patient Driven Payment Model) optimization and case mix index maximization.
Manage Medicaid rate applications, cost reporting, and state-specific reimbursement methodologies to ensure maximum allowable reimbursement.
Extensive experience with
Cost Reporting
is a must.
Analyze payment methodologies, PDPM categories, regulatory changes, and reimbursement trends specific to post-acute and long-term care to identify risks and opportunities.
Direct charge master maintenance, ancillary service pricing, and rate setting strategies for therapy services, pharmacy, medical supplies, and other revenue-generating departments.
Oversee Medicare Part A and Part B billing processes, ensuring compliance with skilled nursing PPS requirements and consolidated billing regulations.
Establish and enforce billing, coding, and collections policies and procedures specific to SNF and long-term care settings, including MDS (Minimum Data Set) accuracy and RUG/PDPM optimization.
Partner with clinical teams, MDS coordinators, therapy departments, and nursing leadership to ensure documentation accurately supports case mix, RUG levels, and reimbursement requirements.
Provide expert guidance on SNF coding, Medicare coverage criteria (3-day hospital stay requirements, skilled need), therapy utilization, and payer reimbursement practices.
Lead initiatives to streamline claims processing, reduce Medicare and Medicaid denials, accelerate cash flow, and enhance revenue capture efficiency.
Develop and implement admissions and census management strategies to optimize occupancy rates and payor mix across all facilities.
Oversee managed care relationships and ensure effective coordination with hospitals, ACOs, and referral sources to drive admissions.
Collaborate with executive leadership on strategic planning, financial forecasting, facility acquisitions or expansions, and value-based care initiatives.
Monitor quality metrics (star ratings, rehospitalization rates, discharge to community) that impact reimbursement and competitive positioning.
Build and mentor high-performing teams across revenue cycle, admissions, utilization review, case management, and payer relations functions.
Represent the organization in industry forums, state Medicaid meetings, payer negotiations, hospital partnerships, and with regulatory agencies including state survey departments.
Drive innovation in revenue enhancement through technology adoption (billing systems, clinical documentation tools), process improvement, and service line development (specialty programs, short-stay rehabilitation).
Ensure compliance with federal and state regulations specific to SNF operations, including Medicare Conditions of Participation and state licensure requirements.
Requirements
Bachelor's degree required; Master's degree in Healthcare Administration, Business Administration, Finance, or related field strongly preferred.
Minimum of 12-15 years of progressive experience in healthcare revenue management
with significant experience in skilled nursing facilities and/or long-term care settings , including at least 7 years in senior leadership capacity.
Proven track record of driving significant revenue growth, census improvement, and operational excellence in post-acute or long-term care environments.
Deep understanding of SNF payment methodologies, including
Medicare PDPM, Medicaid reimbursement systems, managed care contracting, and Medicare Advantage .
Expert knowledge of
MDS 3.0 assessment processes, case mix optimization, and the relationship between clinical documentation and reimbursement .
Demonstrated success developing and executing revenue strategies that optimize financial performance, payor mix, and market position in competitive SNF markets.
Strong expertise in SNF-specific revenue cycle management, including Medicare Part A billing, therapy billing (Part B), consolidated billing rules, and Medicaid cost reporting.
Experience with
hospital-SNF relationships, discharge planning partnerships, and post-acute care networks .
Comprehensive knowledge of healthcare regulations specific to skilled nursing, including
CMS Conditions of Participation, state survey processes, Medicare coverage guidelines, and SNF quality reporting programs .
Understanding of
quality-based reimbursement programs, SNF Value-Based Purchasing (VBP), and star rating systems
and their impact on revenue.
Exceptional analytical, negotiation, strategic thinking, and communication skills.
Ability to translate complex reimbursement concepts (PDPM categories, case mix, per diem rates) into actionable strategies for clinical and operational teams.
Demonstrated adaptability to navigate the evolving post-acute care landscape, including shifts toward value-based care and managed care penetration.
Results-driven leadership style with proven ability to build, inspire, and lead cross-functional teams in multi-site SNF or long-term care organizations.
Strong executive presence with the ability to influence and collaborate effectively with facility administrators, directors of nursing, therapy directors, and corporate leadership.
Benefits
Medical Insurance
Dental Insurance
Vision Insurance
Disability Insurance
Employee Assistance Program
401(k) with employer contribution
Life Insurance
Generous Paid Time Off
Additional Benefits
Telemedicine:
$0 co-pay for telemedicine appointments, providing easy access to medical consultations from the comfort of your home.
Unlimited Assistance:
Receive unlimited support for legal, financial, childcare, elder care, and more—designed to support your personal and family well-being.
Mayo Clinic Programs:
Access exclusive programs from the Mayo Clinic, including resources for workouts, lifestyle, mental health, and diet to promote a balanced and healthy lifestyle.
These additional benefits are available to you without reducing your take-home pay!
We are an equal opportunity employer.
#J-18808-Ljbffr
Position Overview We are currently seeking a
Chief Revenue Officer (CRO)
to lead our revenue generation strategy and optimize financial performance across our skilled nursing facilities and long-term care operations.
Job Responsibilities and Duties
Develop and execute comprehensive revenue strategies to drive census growth, payor mix optimization, and financial performance across all skilled nursing and long-term care service lines.
Lead contract negotiations with Medicare, Medicaid, Managed Care Organizations (MCOs), Medicare Advantage plans, and commercial payers to secure favorable reimbursement rates and terms.
Oversee skilled nursing facility (SNF) prospective payment system (PPS) management, including PDPM (Patient Driven Payment Model) optimization and case mix index maximization.
Manage Medicaid rate applications, cost reporting, and state-specific reimbursement methodologies to ensure maximum allowable reimbursement.
Extensive experience with
Cost Reporting
is a must.
Analyze payment methodologies, PDPM categories, regulatory changes, and reimbursement trends specific to post-acute and long-term care to identify risks and opportunities.
Direct charge master maintenance, ancillary service pricing, and rate setting strategies for therapy services, pharmacy, medical supplies, and other revenue-generating departments.
Oversee Medicare Part A and Part B billing processes, ensuring compliance with skilled nursing PPS requirements and consolidated billing regulations.
Establish and enforce billing, coding, and collections policies and procedures specific to SNF and long-term care settings, including MDS (Minimum Data Set) accuracy and RUG/PDPM optimization.
Partner with clinical teams, MDS coordinators, therapy departments, and nursing leadership to ensure documentation accurately supports case mix, RUG levels, and reimbursement requirements.
Provide expert guidance on SNF coding, Medicare coverage criteria (3-day hospital stay requirements, skilled need), therapy utilization, and payer reimbursement practices.
Lead initiatives to streamline claims processing, reduce Medicare and Medicaid denials, accelerate cash flow, and enhance revenue capture efficiency.
Develop and implement admissions and census management strategies to optimize occupancy rates and payor mix across all facilities.
Oversee managed care relationships and ensure effective coordination with hospitals, ACOs, and referral sources to drive admissions.
Collaborate with executive leadership on strategic planning, financial forecasting, facility acquisitions or expansions, and value-based care initiatives.
Monitor quality metrics (star ratings, rehospitalization rates, discharge to community) that impact reimbursement and competitive positioning.
Build and mentor high-performing teams across revenue cycle, admissions, utilization review, case management, and payer relations functions.
Represent the organization in industry forums, state Medicaid meetings, payer negotiations, hospital partnerships, and with regulatory agencies including state survey departments.
Drive innovation in revenue enhancement through technology adoption (billing systems, clinical documentation tools), process improvement, and service line development (specialty programs, short-stay rehabilitation).
Ensure compliance with federal and state regulations specific to SNF operations, including Medicare Conditions of Participation and state licensure requirements.
Requirements
Bachelor's degree required; Master's degree in Healthcare Administration, Business Administration, Finance, or related field strongly preferred.
Minimum of 12-15 years of progressive experience in healthcare revenue management
with significant experience in skilled nursing facilities and/or long-term care settings , including at least 7 years in senior leadership capacity.
Proven track record of driving significant revenue growth, census improvement, and operational excellence in post-acute or long-term care environments.
Deep understanding of SNF payment methodologies, including
Medicare PDPM, Medicaid reimbursement systems, managed care contracting, and Medicare Advantage .
Expert knowledge of
MDS 3.0 assessment processes, case mix optimization, and the relationship between clinical documentation and reimbursement .
Demonstrated success developing and executing revenue strategies that optimize financial performance, payor mix, and market position in competitive SNF markets.
Strong expertise in SNF-specific revenue cycle management, including Medicare Part A billing, therapy billing (Part B), consolidated billing rules, and Medicaid cost reporting.
Experience with
hospital-SNF relationships, discharge planning partnerships, and post-acute care networks .
Comprehensive knowledge of healthcare regulations specific to skilled nursing, including
CMS Conditions of Participation, state survey processes, Medicare coverage guidelines, and SNF quality reporting programs .
Understanding of
quality-based reimbursement programs, SNF Value-Based Purchasing (VBP), and star rating systems
and their impact on revenue.
Exceptional analytical, negotiation, strategic thinking, and communication skills.
Ability to translate complex reimbursement concepts (PDPM categories, case mix, per diem rates) into actionable strategies for clinical and operational teams.
Demonstrated adaptability to navigate the evolving post-acute care landscape, including shifts toward value-based care and managed care penetration.
Results-driven leadership style with proven ability to build, inspire, and lead cross-functional teams in multi-site SNF or long-term care organizations.
Strong executive presence with the ability to influence and collaborate effectively with facility administrators, directors of nursing, therapy directors, and corporate leadership.
Benefits
Medical Insurance
Dental Insurance
Vision Insurance
Disability Insurance
Employee Assistance Program
401(k) with employer contribution
Life Insurance
Generous Paid Time Off
Additional Benefits
Telemedicine:
$0 co-pay for telemedicine appointments, providing easy access to medical consultations from the comfort of your home.
Unlimited Assistance:
Receive unlimited support for legal, financial, childcare, elder care, and more—designed to support your personal and family well-being.
Mayo Clinic Programs:
Access exclusive programs from the Mayo Clinic, including resources for workouts, lifestyle, mental health, and diet to promote a balanced and healthy lifestyle.
These additional benefits are available to you without reducing your take-home pay!
We are an equal opportunity employer.
#J-18808-Ljbffr