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Salary: 93,385.50-140,068.50 USD

Facility: Administrative Regional Training Cntr

Shift: Shift 1

Status: Full Time FTE: 1.000000

Bargaining Unit: ACE Associates

Exempt from Overtime: Exempt: Yes

Work Schedule: Days

Hours:

Generally M-F 7-3, 8-4 with varied hours as needed based on normal management responsibilities

Summary:

Under the direction of the Director, Middle Revenue Cycle, the Manager, Revenue Integrity (RI) manages a professional team to monitor, review, plan, implement and report various revenue management strategies to ensure accurate and optimal revenue capture across the enterprise. This team will have primary responsibility for overseeing the charge description masters (CDMs) across Catholic Health. The manager will oversee project managers who provide PM and data analysis expertise to various revenue cycle departments across CHS. The team is responsible for creating complex visualizations, reports and dashboards to identify and support revenue cycle opportunities using a range of technology tools. As such, the manager is expected to have a broad and/or deep knowledge in a variety of business intelligence and data visualization tools used by the organization and be able to make recommendations concerning which tools are appropriate depending on the project or request. Central to this role is an understanding and management of relationships between revenue cycle and other clinical and non-clinical departments of Catholic Health. This position is responsible for planning and organizing the initiatives supporting revenue capture and integrity, outpatient clinical documentation improvement (CDI), maintaining compliance with all regulatory requirements, directing and providing oversight for the staff, maintaining knowledge of current events and innovations to enhance the revenue cycle, communicating with key stakeholders within the ministries, and ensuring the highest level of customer satisfaction to our customers, both internal and external. This position is responsible for coordination of the CDM maintenance process to ensure all federal, state and local payer requirements are incorporated into the CDM; collaboration with clinical areas as it relates to the revenue cycle, the CDM, the charge capture process and charge reconciliation; collaborative oversight and support of revenue cycle operational improvements in response to opportunities, problems and denials; and monitoring, auditing and measuring the effectiveness of the revenue cycle process including charge capture and reconciliation procedures. This position will also build and maintain the technical infrastructure, including reports, dashboards and extracts, to support the ongoing and future needs of the clinical and business intelligence portion of work directly related to their scope and under the guidance of Director Clinical and Business Intelligence. In addition, the Project Manager will work to support scope reporting needs in EPIC.

Responsibilities:

EDUCATION

+ Bachelor's Degree in finance, computer science or healthcare related field required

+ Coding credential (CPC, CCA, CCS, RHIT) preferred

EXPERIENCE

+ Minimum of three (3) years of experience in chargemaster, coding, billing and/or reimbursement associated with all aspects of the revenue cycle

+ Minimum of three (3) years of experience in a supervisory/management role, preferably in a multi-hospital system

+ Business process improvement and/or change management experience required

+ Healthcare revenue integrity experience required

+ Experience in data extraction, manipulation and interpretation skills, including understanding and designing complex linking rules to pull disparate data set together

+ Experience in data mining with the ability to analyze vast data sets to identify trends, issues or opportunities and implement actionable strategies for improvement

KNOWLEDGE, SKILL AND ABILITY

+ Proficiency in Microsoft Excel and other Microsoft Office applications

+ Excellent communication (written and verbal), time management, presentation and organizational skills

+ Ability to develop, engage, challenge and mentor others; possesses core management skills that include the ability to interface and collaborate effectively with management, staff and senior executives

+ Ability to achieve support for initiatives and build consensus among stakeholders; encourages teamwork, accountability, communication and service orientation

+ Demonstrated skill in exercising initiative, judgment, problem-solving and metric based decision making

+ Ability to look for opportunities and issues in vast data sets without a pre-determined problem

+ Demonstrated data extraction, manipulation and interpretation skills. Ability to analyze vast data sets to identify trends, issues or opportunities and implement actionable strategies for improvement

+ Proven ability to lead interdisciplinary teams to meet project milestones and achieve measurable performance outcomes

+ Knowledge and understanding of current healthcare financial challenges and the ability to connect these challenges to the revenue cycle for operational improvement opportunities

+ Strong revenue cycle knowledge base, including in-depth knowledge of government payers' requirements related to coding, pricing and billing rules including Medicare and other payers

+ Ability to read and interpret CMS and other payer billing and regulatory requirements and apply principles to current and future operational goals

+ Basic understanding of clinical concepts and services

+ Ability to multi task in a demanding environment, while maintaining a positive attitude

WORKING CONDITIONS:

+ Office Environment

+ Some local travel is required

REQNUMBER: 38572