Revenue Integrity Director

JOB SUMMARY

The Director of Revenue Integrity serves in a senior leadership capacity and demonstrates client and unit-specific leadership to Revenue Integrity personnel by designing, directing, and executing key Conifer Revenue Integrity processes. This includes Charge Description Master (“CDM”) and charge practice initiatives and processes; facilitating revenue management and revenue protection for large, national integrated health systems; regulatory review, reporting and implementation; and projects requiring expertise across multiple hospitals and business units.  The Director provides clarity for short/long term objectives, initiative prioritization, and feedback to Managers for individual and professional development of Revenue Integrity resources.  The Director leverages project management skills, analytical skills, and time management skills to ensure all requirements are accomplished within established timeframes.  Interfaces with highest levels of Client Executive personnel.

 

• Direct Revenue Integrity personnel in evaluating, reviewing, planning, implementing, and reporting various revenue management strategies to ensure CDM integrity.  Maintain subject-matter expertise and capability on all clinical and diagnostic service lines related to Conifer revenue cycle operations, claims generation and compliance.
• Influence client resources implementing CDM and/or charge practice corrective measures and monitoring tools to safeguard Conifer revenue cycle operations; provide oversight for Revenue Integrity personnel monitoring statistics/key performance indicators to achieve sustainability of changes and compliance with regulatory/non-regulatory directives.
• Assume lead role and/or provide direction/oversight for special projects and special studies as required for new client integration, system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, hospital mergers, etc.
• Serve as primary advisor to and collaboratively with Client/Conifer Senior Executives to ensure requirements are met in the most efficient and cost-effective manner; provides direction to clients for implementation of multiple regulatory requirements.
• Serve as mentor and coach for Revenue Integrity personnel and as a resource for manager-level associates.

 

• Maintain a high-level understanding of accounting and general ledger practices as it relates to Revenue Cycle metrics; guide client personnel on establishing charges in appropriate revenue centers to positively affect revenue reporting

 

FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense):  Adherence to established/approved annual budget

 

SUPERVISORY RESPONSIBILITIES 

This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Direct Reports (incl. titles) : Revenue Integrity Manager/Supervisor

Indirect Reports (incl. titles) : Charge Review Specialist I-II, Revenue Integrity Analyst I-III, Charge Audit Specialist

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

• Ability to set direction for large analyst team consistent with Conifer senior leadership vision and approach for executing strategic revenue management solutions
• Demonstrated critical-thinking skills with proven ability to make sound decisions
• Strong interpersonal communication and presentation skills, effectively presenting information to executives, management, facility groups, and/or individuals
• Ability to present ideas effectively in formal and informal situations; conveys thoughts clearly and concisely
• Ability to manage multiple projects/initiatives simultaneously, including resourcing
• Ability to solve complex issues/inquiries from all levels of personnel independently and in a timely manner 
• Ability to define problems, collect data, establish facts, draw valid conclusions, and make recommen