"Alerted.org

Current Emanate Health Employees - Please log into your Workday account to apply

Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals.

On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country.

J** **ob Summary

The Director of Revenue Integrity & Clinical Utilization Review provides clinical oversight and operational leadership for clinical utilization review, charge capture, and revenue integrity functions. This position is responsible for managing medical necessity reviews, payer audits, clinical denials, and charge accuracy across the care continuum. The director develops and implements strategies to prevent revenue leakage, ensure defensible billing, and align operations with regulatory standards to optimize reimbursement and patient care outcomes.

Job Requirements

M** **inimum Education Requirement :

Bachelor’s Degree in Nursing (BSN) or Healthcare Administration preferred.

Minimum Experience Requirement :

Minimum ten (10) years of combined experience in utilization management, revenue cycle, or charge integrity; at least two (2) years in a supervisory/leadership role. Proficient in InterQual/MCG, payer criteria, and clinical documentation standards. Working knowledge of charge capture workflows, billing practices, and revenue cycle systems. Experience with Meditech, Cerner, or other EMR and charge capture platforms preferred.

Minimum License Requirement :

California RN license.

Delivering world-class health care one patient at a time.

Pay Range:

$72.60 - $106.73

We are more than just a health system. At Emanate Health, we are a catalyst for change and a beacon for healthier lives.

When you come to any one of our locations (https://www.emanatehealth.org/locations/) , you'll be treated like family. And as part of our family, you can rest easy knowing we'll do whatever it takes to benefit your health and wellness.

Our mission

Emanate Health exists to help people keep well in body, mind and spirit by providing quality health care services in a safe, compassionate environment.

Our vision

We are an integral partner in elevating our communities' health.

Our values

Patients and their families are the reason we are here. We want them to experience excellence in all we do through the quality of our services, our teamwork, and our commitment to a caring, safe and compassionate environment.

**Respect.** We affirm the rights, dignity, individuality and worth of each person we serve and of each other.

**Excellence.** We maintain an unrelenting drive for excellence, quality and safety, and strive to continually improve all that we do.

**Compassion.** We care for each person and each team member as part of our family.

**Integrity.** We believe in fairness and honesty and are guided by our code of ethics.

**Stewardship.** We wisely care for the human, physical and financial resources entrusted to us.

Emanate Health is an Equal Opportunity Employer and does not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify the Human Resources Department by calling 626-858-8515.