PROGRAM MANAGER REVENUE INTEGRITY COMPLIANCE - CORPORATE COMPLIANCE

Salary Range: $49.6300 - $81.9300 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education.

The Program Manager Revenue Integrity Compliance supports implementation of the Revenue Integrity Compliance Program for Hoag Memorial Hospital Presbyterian and its affiliated companies (collectively “Hoag”). The Program Manager Revenue Integrity Compliance is a key corporate compliance role providing onsite support of billing, coding and revenue cycle compliance related matters for Hoag enterprise-wide. Possesses working knowledge of revenue cycle operations, regulatory and compliance rules and regulations, various payer reimbursement practices and government billing audits. In collaboration with the Sr. Principal, Revenue Integrity Compliance, the implements processes to prevent fraud, waste, and abuse. Researches and interprets billing and coding guidelines and CMS reimbursement regulations applicable to Hoag service lines. Develops presentations, education and provide training on new standards and conduct audits to ensure compliance. Under limited supervision, supports the operations of the Revenue Integrity Compliance Program which includes special projects, assessment and analysis, performing audits, conducting investigations, responding to compliance questions and working with the revenue cycle departments. Performs other duties as assigned.

Education and Experience

• A minimum of four (4) years of relevant compliance and/or revenue cycle experience in an acute care setting or multi-specialty medical group.
• Working knowledge of government and commercial billing and coding regulations and guidance.
• Familiarity with Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs) and other CMS billing and coding guidelines for Hoag services.

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.