Revenue Integrity Director.
HealthRise is a dynamic healthcare consulting firm laser focused on revenue cycle management optimization and sustainable success. We hire and retain the industry’s top talent – we push boundaries and thrive on fierce conversations, which is why our track record is unmatched. HealthRise cultivates a culture of accountability; our team members aren’t satisfied with the status quo. We look for game changers who are driven by opportunity to grow personally and professionally, make money and feel empowered. A tech-enabled firm that stays ahead of the rapidly evolving healthcare industry, HealthRise deploys a Full Continuum approach that begins with an operational foundation, builds with our expert consulting and ends with relentless execution.
The resource will serve as the Revenue Integrity department Interim Director, managing and maintaining existing operations while working side-by-side with hospital’s revenue cycle team to assess current state and driving forward HealthRise initiatives to achieve improved outcomes and better operating practices for the client.
This position will require traveling to a client site four days a week and occasionally to our corporate headquarters in Southfield, Michigan. Location of the client site varies, so candidates must be flexible with travel.
This position will require traveling to client sites four days a week and to our corporate headquarters in Southfield, Michigan. Location of the client site varies, so candidates must be flexible with travel.
Serve as Interim Director of Revenue Integrity Department:
- Maintain current worklist levels by resolving Revenue Integrity Errors
- Maintain chargemaster with timely response and organized approach to executing ad-hoc change requests and recurring (quarterly/annually) updates
- Manage existing staff members – drive accountability, improve productivity, and closely monitor metrics
- Collaborate with client revenue cycle team and other departments to facilitate resolution of immediate process issues and implement solutions
- Performs all related duties or special projects as assigned/required
- Serve as Liaison with Payer Strategies, Patient Business Services, HIM, and Patient Access
- Coordinate with Physician Advisors, Case Management, and other Department Leadership for denials resolution
- Supervision and coordination of Chargemaster management functions
- Monitor and ensure proper revenue generation across clinical departments
- Maintain compliance with all government and third-party payor requirements
- Work with external departments to perform applicable analyses
Perform Assessment of Current State and Address Areas for Improvement
- Develop workplans, project tasks, and manage project to provide comprehensive assessment of Revenue Integrity function relating to structure, processes, policies
- Provide recommendations and take implementation steps following assessment on CDM maintenance, charge audit function, team staffing and responsibilities, charge reconciliation, HIS edits, and all other Revenue Integrity related functions
- Provide Decision Support and Analytics as necessary to support Finance/Revenue Cycle teams
- Experience in an Epic, Meditech and/or HealthQuest EHR based project/environment is preferred
Creation of Clinical Charge Champion Structure and Charge Reconciliation Processes
- Develop sustainable process to reconcile all PB/HB charges with increased clinical department engagement and accountability
- Create and lead charge champion meetings to increase charge integrity accountability to the clinical departments
- Document and communicate changes/improvements in client stakeholder meetings
Support Transition and Department Hand-Off
- Support sourcing/onboarding of new Revenue Integrity department leader following engagement and successfully transition department new leader
- Development of all necessary materials hand-off materials (including assessment/plan above) to ensure sustainable results
A Director must have vast experience in project and/or program management. He/she must possess outstanding communication, listening and interpersonal skills and be comfortable directing or challenging clients and coworkers. The successful candidate will be able to establish credibility and rapport quickly with a broad set of partner and internal team members. He/she will have an understanding of the healthcare revenue cycle and will be able to drive strategic planning and change management activities in this area.
The ideal Director candidate represents and demonstrates our CORE VALUES:
- ALL IN– We all work collectively toward the same goal: brightening our company’s future.
- HEALTHY RELATIONSHIPS– We are trustworthy and accountable, establishing strong, lasting bonds with our partners and each other.
- CONTINUOUS IMPROVEMENT– We aim to improve every day, both personally and professionally.
- COMPETITIVE– We push and encourage each other to be the best, knowing our team becomes stronger when we strive for greatness together.
- EXCELLENCE– We aspire to get it right every time, delivering professional, high quality results.
- Bachelor’s degree required
- Master’s degree in Business Administration or related field preferred
- Coding certification (e.g. RHIT, CCS) preferred, but not required; deep familiarity with AMA guidelines for chargemaster maintenance necessary
- 10+ years project management and preferably recent PM experience in Meditech, HealthQuest or Epic based projects
- 10+ years’ experience in hospital revenue cycle environment
- 5-7+ years consulting in a healthcare management related field
- Epic expertise within revenue cycle applications (Resolute HB experience/certification preferred), including subject matter expertise with EAP record maintenance and charging/charge reconciliation best practices within Epic
- Solid understanding of revenue cycle workflow in the hospital environment (registration, scheduling, coding, billing, contracting)
- A high degree of self-motivation, versatility and flexibility
- In-depth knowledge of the complete healthcare revenue cycle
- Ability to work closely with groups outside of your organization/control
“Leadership believes – and actively demonstrates – that the people of HealthRise are the cornerstone of sustained growth and client satisfaction. Working here is electric.”
– Laura Stocks, Manager
“Every day, my team and I develop innovative solutions to meet our partners’ unique needs. I am challenged to think differently and consistently improve my skills and gain experience through the process. My work with the Volunteer Committee fills my need to be a part of a company that cares.”
– Emily Smith, Manager
“The minute I walk through the door at HealthRise, I feel the energy and enthusiasm this team has for each other and the work they do. I’m happy to not be in a cube crunching numbers. Instead, I am in the field, working with partners, building relationships and coming up with new solutions every day.”
-Ian Sullivan, Analyst
Driven to succeed? Here’s more Fuel.
Watch practical, inspired snippets from HealthRise CEO David Farbman, who talks about career challenges, how to face them down and ultimately come out stronger. Each video is two minutes or less and could be just the fuel you need to spark your own success.