Gene Reyes
Summary
Dynamic healthcare executive with a proven track record at CHA Hollywood Presbyterian Medical Center, excelling in revenue cycle management and strategic planning. Expert in contract negotiation and team leadership, achieving a 5% annual increase in reimbursement while enhancing patient satisfaction through process improvement and compliance monitoring.
Overview
28
28
years of professional experience
Work History
Consultant Contracts/Provider Relations/Claims/Compliance
Partnership HealthPlan
Fairfield
11.2024 - 07.2025
- Collaborated with the COO to guide teams lacking leadership, enhancing organizational clarity and fostering a culture of teamwork.
- Negotiated new and re-negotiated contracts with Large Health Systems that wanted to terminate or not contract with Partnership HealthPlan.
- Streamlined Provider Relations processes, achieving smoother operations and improved provider satisfaction through efficient communication.
- Analyzed hospital and physician adequacy issues, delivering actionable insights that addressed critical concerns for boarding states.
- Implemented a comprehensive Claims Report Card for providers, driving transparency and accountability in claims management.
- Reorganized Contracting Area, ensuring alignment with compliance standards and improving contract negotiation efficiency.
- Evaluated provider contracts to ensure compliance, resulting in improved negotiation outcomes and reduced legal risks.
Vice President of Revenue Cycle
CHA Hollywood Presbyterian Medical Center
Los Angeles
08.2022 - 11.2024
- Negotiated multi-year agreements with regional Medicaid (Medi-Cal) managed care, securing reimbursement above state benchmark and improving gains by 5% annually.
- Led contract negotiations with national Medicare Advantage, commercial, and dual-eligible payers, achieving rate increases netting +$3M annually.
- Partnered with Revenue Cycle, Case Management, and Finance to align workflows with payer contracts, improving collections efficiency, raising patient satisfaction scores, and lowering readmissions.
- Conducted thorough analysis of revenue cycle metrics, leading to the establishment of acceptable KPIs and measurable improvements across departments.
- Fostered partnerships with top payors, enhancing collaboration and increasing successful claims processing for improved revenue generation.
- Implemented best practices in process improvement, resulting in a marked decrease in DNFB from 8 days to 4, optimizing operational efficiency.
- Provided strategic oversight and mentorship to diverse teams, cultivating a culture of compliance and operational excellence within the Revenue Cycle.
- Spearheaded initiatives that reduced AR days from 72 to 60, significantly enhancing cash flow and overall financial health.
Director of Revenue Cycle-VP Revenue Cycle
County of Santa Clara
San Jose
02.2020 - 08.2022
- Led revenue cycle functions, reducing hospital AR Days from 75 to 60, enhancing cash flow.
- Developed policies to meet system needs, improving patient and financial outcomes.
- Managed patient accounts, optimizing collections and cash flow.
- Implemented an enterprise authorization unit, streamlining processes and enhancing patient account management for improved operational efficiency.
- Partnered with Revenue Cycle, Case Management, and Finance to align workflows with payer contracts, improving collections efficiency, raising patient satisfaction scores, and lowering readmissions.
- Optimized contract compliance monitoring by implementing payer performance dashboards, identifying denial trends, and initiating process changes that cut contractual underpayments by 6%.
- Analyzed departmental budgets, contributing to annual preparation and ensuring optimal resource allocation across all revenue cycle departments.
- Restructured patient access and business office functions, leading to a decrease in DNFB from 12 days to 8 days, significantly enhancing operational performance.
- Fostered a collaborative environment by establishing clear goals and KPIs for all departments, promoting accountability and measurable improvements.
- Streamlined revenue cycle operations, achieving substantial improvements in cash flow and reducing accounts receivable days.
Regional Director of Revenue Cycle Division I
Prime Healthcare
Ontario
08.2018 - 02.2020
- Led revenue cycle functions, improving AR days from 70 to 55.
- Partnered with Revenue Cycle, Case Management, and Finance to align workflows with payer contracts, improving collections efficiency, raising patient satisfaction scores, and lowering readmissions.
- Strengthened payer relationships by launching quarterly joint-operating meetings with top commercial and government payers, reducing disputes and accelerating claims resolution.
- Implemented strategic metrics for budget compliance and productivity.
- Enhanced cash collections, surpassing fiscal year targets.
- Reduced DNFB from 22 to 15 days, optimizing revenue integrity.
- Streamlined revenue cycle operations, resulting in a notable reduction of AR Days from 70 to 55, enhancing cash flow and operational efficiency.
- Developed strategic performance metrics to monitor budget compliance, leading to measurable improvements in departmental productivity and accountability.
- Restructured Patient Access and Authorization processes, significantly decreasing denial rates and improving patient experience through effective Case Management collaboration.
- Coordinated cross-departmental goals, fostering teamwork and ensuring each area under my oversight met established KPIs, resulting in improved overall performance.
- Provided leadership and mentorship to revenue cycle teams, promoting a culture of continuous improvement and achieving substantial growth in cash collections.
- Championed value-based and risk-based arrangements, including shared-savings and P4P, boosting quality scores and reducing avoidable readmissions by 3%.
- Spearheaded initiatives to enhance patient access processes, resulting in improved patient satisfaction and reduced wait times.
Executive Director of Revenue Cycle
Boca Raton Regional Hospital
Baco Raton
07.2017 - 03.2018
- Successful implementation of Cerner EMR.
- Reduced AR Days from 55 days to 40 days with a goal of 35 days.
- Partnered with Revenue Cycle, Case Management, and Finance to align workflows with payer contracts, improving collections efficiency, raising patient satisfaction scores, and lowering readmissions.
- Decreased DNFB from 13 days to 3 days.
- Restructured all Patient Access areas, Patient Accounts, as well as HIM.
- Implemented a robust CDI program with an ROI of $8 million to the bottom line.
- Reduced physician division AR Days from 45 days to 36.5 days.
- Established goals for all departments under the area of responsibility.
- Increased cash collections and on target to exceed FYT cash.
Executive Director of Revenue Cycle
Riverside University Medical Center
Moreno Valley
02.2015 - 07.2017
- Successful implementation of EPIC HB and PB EMR 'Big Bang'.
- Reduced AR Days from 246 days to 64 days with a goal of 55 days.
- Decreased DNFB from 8 days to 5 days.
- Partnered with Revenue Cycle, Case Management, and Finance to align workflows with payer contracts, improving collections efficiency, raising patient satisfaction scores, and lowering readmissions.
- Strengthened payer relationships by launching quarterly joint-operating meetings with top commercial and government payers, reducing disputes and accelerating claims resolution.
- Restructured all registration areas, Case Management areas, Patient Accounts.
- Implemented new billing system for both hospital claims and physician claims.
- Reduced physician division AR Days from 45 days to 36.5 days.
- Established goals for all departments under my area of responsibility.
Executive Director of Revenue Cycle
The Christ Hospital
Cincinnati
11.2013 - 10.2014
Vice President, Patient Financial Services
CommonWealth Health / Community Health System
Wilkes-Barre
04.2013 - 11.2013
Director of Revenue Cycle Operations, Hospital/Patient Access
Lucile Packard Children’s Hospital at Stanford Hospital
Palo Alto
10.2010 - 04.2013
Regional Manager Patient Financial Services; Region I
White Memorial Medical Center - Adventist Health
Los Angeles
10.2001 - 10.2010
Director of Operations, Centinela Central Business Office
Tenet Health Systems
Inglewood
09.1997 - 10.2001
Education
Bachelor of Science - HEALTHCARE ADMINISTRATION
New England College
Hennessey, OK10.2015
Associate of Science - SOCIAL SCIENCE
Barstow Community College
Barstow, CA05.2010
Skills
- Revenue Cycle Management
- Healthcare Administration
- Patient Access
- Financial Management
- Team Leadership
- Process Improvement
- Strategic Planning
- Healthcare Compliance
- Performance Metrics
- Budget Management
- Epic
- Cerner
- McKesson
- MediTech
- Contract negotiation
- Claims management
- Revenue cycle analysis
- Compliance monitoring
- Process improvement
- Team leadership
- Patient satisfaction
Phone
cell, 951-809-5158
Additional Information
Vice President of California Association of Healthcare Admissions Management (CAHAM), Member of Healthcare Financial Management Association (HFMA), Upon Request
References
References available upon request.
Timeline
Consultant Contracts/Provider Relations/Claims/Compliance
Partnership HealthPlan
11.2024 - 07.2025
Vice President of Revenue Cycle
CHA Hollywood Presbyterian Medical Center
08.2022 - 11.2024
Director of Revenue Cycle-VP Revenue Cycle
County of Santa Clara
02.2020 - 08.2022
Regional Director of Revenue Cycle Division I
Prime Healthcare
08.2018 - 02.2020
Executive Director of Revenue Cycle
Boca Raton Regional Hospital
07.2017 - 03.2018
Executive Director of Revenue Cycle
Riverside University Medical Center
02.2015 - 07.2017
Executive Director of Revenue Cycle
The Christ Hospital
11.2013 - 10.2014
Vice President, Patient Financial Services
CommonWealth Health / Community Health System
04.2013 - 11.2013
Director of Revenue Cycle Operations, Hospital/Patient Access
Lucile Packard Children’s Hospital at Stanford Hospital
10.2010 - 04.2013
Regional Manager Patient Financial Services; Region I
White Memorial Medical Center - Adventist Health
10.2001 - 10.2010
Director of Operations, Centinela Central Business Office
Tenet Health Systems
09.1997 - 10.2001
Bachelor of Science - HEALTHCARE ADMINISTRATION
New England College
Associate of Science - SOCIAL SCIENCE
Barstow Community College
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