What are the responsibilities and job description for the Revenue Integrity Manager - Full Time position at Hutchinson Regional Healthcare System?
GENERAL SUMMARY:
This position reports to the Decision Support Director and is primarily responsible for overseeing various revenue integrity analysts.
Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
This position reports to the Decision Support Director and is primarily responsible for overseeing various revenue integrity analysts.
Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
ESSENTIAL FUNCTIONS:
- Develops and implements a comprehensive revenue integrity strategy aligned with the hospital's overall goals and objectives. This strategy addresses key areas such as charge master management, reimbursement variance, and payor contract variances.
- Establishes and maintains a strong revenue integrity governance framework, including policies, procedures, and standards that are clearly defined, communicated, and adhered to by all relevant staff.
- Leads and supervises a team of revenue integrity analysts, providing guidance, training, and support to ensure optimal performance. Delegates tasks effectively, empower team members, and fosters a positive and collaborative work environment.
- Conducts regular audits and reviews to assess the effectiveness of revenue integrity processes and identify areas for improvement. Develops and implements action plans to address identified issues and enhance efficiency and compliance.
- Collaborates with cross-functional teams to ensure a coordinated and integrated approach to revenue integrity. Facilitates effective communication and information sharing among all stakeholders, including finance, billing, coding, clinical departments, and other relevant departments.
- Stays up to date on industry trends, regulatory changes, and best practices in revenue integrity.
- Conducts in-depth analyses of payer reimbursement methodologies to identify potential areas for improvement, such as underpaid claims or missed reimbursement opportunities.
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Manages/oversees special projects and special studies as required for system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, or other projects including, but not limited to:
- Assist with pricing initiatives such as strategic pricing, across-the-board increases, tiered pricing, pricing transparency; conducts interim pricing reviews and performs financial analyses for strategic initiatives.
- Manage day to day operations managing staff and ensuring efficient workflows
- Organize resources and establish priorities.
- Develop, plan and implement short and long-range goals.
- Foster a cooperative work environment.
- Effectively manage staff, ensure employee development and oversee performance management
MINIMUM KNOWLEDGE AND SKILLS REQUIRED:
- Strong quantitative, analytic, and problem-solving skills.
- Strong organizational skills.
- Strong time management, attention to detail, and follow through.
- Excellent interpersonal and communication skills.
- Microsoft Excel, Google and Cerner experience highly desirable.
PREFERRED KNOWLEDGE AND SKILLS REQUIRED:
- Solid understanding of the reimbursement systems including IPPS, OPPS, DRG, etc.
- Extensive knowledge of charge creation, processing and reconciliation in a health care environment.
REQUIRED BEHAVIORAL SKILLS:
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Integrity:
- A personal presence which is characterized by a sense of honesty and the willingness to do the right thing.
- The ability to role model, inspire and motivate others to promote the philosophy, mission, vision, goals and values of Hutchinson Regional Healthcare System.
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Compassion:
- A personal presence which is characterized by a sense of caring that is reflected in a high level of empathy and customer service with all that we come in contact.
- Ability to manage conflict, consider other points of view, and offer alternative solutions without jeopardizing overall project direction and the ability to manage customer expectations.
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Accountability:
- Demonstrated track record of ownership of situations, projects and issues.
- Able to work autonomously and have a high degree of flexibility to adapt to changing projects, priorities and work volumes.
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Respect:
- Demonstrated ability to collaborate with a diverse population.
- Treat all internal and external customers with a positive, proactive service orientation.
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Excellence:
- Strong communication and presentation skills with a proven ability to influence and lead teams to conclusion/decision making.
- Proven ability to think strategically but also must be able to lead day-to-day tactical processes.
- Demonstrated ability to manage and provide coaching and leadership on complex projects.
- Must be able to lead and/or facilitate process improvement.
MINIMUM EDUCATION AND EXPERIENCE REQUIRED:
- Bachelor’s degree in Accounting, Finance, or Information Technology.
- Advanced expertise in Excel, BI, EHR/EMR, and Report Writing preferred.
- Six years’ healthcare industry experience preferred (finance, IT, revenue cycle, billing, coding, etc.)
We offer competitive pay, a generous benefit package and a reason to be proud of what you do, every day.
