What are the responsibilities and job description for the DIRECTOR OF REVENUE INTEGRITY position at Froedtert Health?
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Location : US : WI : MENOMONEE FALLS at our WOODLAND PRIME 400 facility.
This job is REMOTE.
FTE : 1.000000
Shift : Shift 1
Job Summary :
Responsible for development, implementation and maintenance of revenue integrity functions, consistent with the mission and vision of Froedtert Thedacare Health. Responsible for the consolidated Charge Description Master (CDM) of all Froedtert Thedacare Health entities [e.g. all hospitals, surgery centers, community physicians (CP), WDL]. Serves as the revenue integrity liaison for the Revenue Cycle and revenue producing departments.Working closely with other departments including service line and department leaders, Managed Care and Finance, responsible for strategic pricing, both gross and net, and implementing appropriate pricing policies within the health system for all services. Team is responsible for performing reimbursement valuation analyses to assist in payer contracting, both fee for service and value-based contracts. Provides data analytics and reporting functions to Managed Care and Revenue Cycle to maximize net reimbursement to the organization. This includes, but is not limited to, claims denials and underpayment analysis, strategic pricing recommendations in payer contracts, and accounting for and making recommendations related to pay-for-performance and revenue at risk programs, for both commercial and government payers.
EXPERIENCE DESCRIPTION :
A minimum of ten years of hospital or professional revenue cycle operations and progressively responsible experience in healthcare financial management is required.
EDUCATION DESCRIPTION :
Bachelor's Degree in Finance or related field is required. In lieu of Bachelors Degree, relevant work experience may be considered.
SPECIAL SKILLS DESCRIPTION :
Strong knowledge of MSDRG and CMS OPPS reimbursement methodologies, CDM management, and strategic pricing are required. Also must be well versed in CMS Advanced Payment Methodologies (APMs). Possesses strong understanding of various reimbursement methodologies and payer billing requirements. Strong qualitative, analytic, and problem solving skills to facilitate decision making related to operational improvements. Strong organizational, communication and collaboration skills.
Perks & Benefits at Froedtert Health
Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following :
- Paid time off
- Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
- Academic Partnership with the Medical College of Wisconsin
- Referral bonuses
- Retirement plan - 403b
- Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
- Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available
The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.
We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.
