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As the Director of Payer Audit – Revenue Cycle, you’ll lead a high-performing, system-wide audit team and set the strategy for pre- and post-payment audit processes. This is more than managing denials—it’s about driving payer behavior change, leveraging data to influence outcomes, and reducing financial risk across a $7B+ health system. If you’re a proven leader with deep expertise in payer audits and a passion for collaboration, innovation, and results, this is your opportunity to make a lasting impact.

The System Director of Payer Audit provides strategic and operational leadership for all payer audit functions across the health system. This role is responsible for overseeing pre- and post-payment audit processes, managing denials and appeals, and driving payer behavior change through data-driven insights and cross-functional collaboration. The Director will lead a centralized team of audit professionals, including RNs, coders, and administrative staff. They will work closely with clinical, compliance, and revenue cycle leaders to ensure audit integrity, optimize reimbursement, and reduce financial risk.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Strategic Oversight & Leadership

+ Lead the system-wide payer audit function, ensuring alignment with organizational goals and revenue cycle strategies.

+ Develop and implement a centralized audit model to streamline intake, triage, appeal, and follow-up processes.

+ Collaborate with stakeholders to identify audit trends, root causes of denials, and opportunities for payer negotiation and contract improvement.

Operational Management

+ Oversee the intake and processing of medical record audit requests, ensuring timely and accurate responses to payers and auditors.

+ Direct the development of appeal strategies and ensure high-quality, evidence-based appeal letters are submitted.

+ Monitor audit volumes, cycle times, and outcomes to drive continuous improvement and resource optimization.

Team Development & Supervision

+ Manage a multidisciplinary team including audit managers, RNs, coders, and support staff.

+ Define role-based workflows and skillset alignment to ensure efficient case routing and resolution.

+ Foster a culture of accountability, innovation, and professional growth.

Data Analytics & Reporting

+ Utilize Epic Correspondence Records and other tools to track audit lifecycle stages and outcomes.

+ Provide regular reporting to executive leadership on audit trends, financial impact, and team performance.

+ Partner with IT and analytics teams to enhance audit tracking and predictive modeling capabilities.

Compliance & Collaboration

+ Ensure compliance with payer policies, CMS guidelines, and internal documentation standards.

+ Serve as a liaison to legal, compliance, and contracting teams on audit-related matters.

+ Represent the organization in payer discussions and external audit forums.

EDUCATION/EXPERIENCE REQUIRED

+ Bachelor’s degree in Nursing, Health Information Management, Business, or related field required; Master’s Preferred.

+ RN, RHIA, RHIT, or CCS credential preferred.

+ Minimum 7 years of progressive leadership experience in payer audit, revenue cycle, or clinical documentation improvement.

+ Demonstrated success in managing large teams and complex audit workflows.

+ Strong knowledge of payer policies, CMS regulations, and Epic systems.

+ Excellent communication, negotiation, and analytical skills.

Additional Information

+ Organization: Corporate Services

+ Department: Revenue Cycle Administration

+ Shift: Day Job

+ Union Code: Not Applicable

Additional Details

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Overview

Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .

Benefits

The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.