Manager Revenue Integrity
Req #: 28876
The Manager Revenue Integrity is responsible for operational leadership of the Revenue Integrity department. This position contributes to the financial strength, compliance and overall performance of Revenue Cycle operations by providing leadership for all Revenue Integrity functions, including hospital and physician (provider) services. The Manager also provides assistance to the Sr. Director Revenue Integrity. The Manager Revenue Integrity serves in a key role to monitor and facilitate improvement in the overall quality, timeliness, completeness, and accuracy of Revenue Integrity processes (such as charge master maintenance, charge compliance and accuracy, payment variance analytics and prevention and overall quality and accuracy of all data flowing through the revenue cycle). Data integrity and reporting of financial performance and impact of improvement initiatives and standard KPIs is required. The Manager will ensure the effectiveness of Revenue Integrity policy, practices and technology platforms. Net revenue/performance improvement goal setting, monitoring and achievement are required.
The position will provide leadership, coordination, and evaluation of Revenue Integrity and is specifically responsible for the following:
- Charge Master Maintenance and Accuracy
- Charge Capture Completeness, Accuracy and Reconciliation
- Payment Variance Analytics, Reporting and Prevention
- Regulatory Adherence across Revenue Cycle departments and organizationally
o Provider Based Status and Facility Enrollment
- Assisting the Senior Director in building and maintaining Revenue Cycle reporting & analytics
o Financial Improvement Goal Setting, Process Improvement, Tracking and Reporting
o Data Trending
o KPI and Operational Dashboards and Reports
o Supporting Organizational Dashboards and Reports
- Vendor Management
- Revenue Informatics development and management
o Systems Support
o Professional Development
o Workflow Redesign and Enhancement
- Supporting Strategic Design of Revenue Cycle Operations
- Collaboration with Finance and Managed Care Contracting leaders to ensure optimal pricing methodology
It is critical that this position be highly effective in delivering the services described above and work harmoniously with leaders and staff across the organization. Effectiveness will be measured in terms of measurable results, commitment, staff engagement and customer satisfaction (at all levels).
Education and Experience:
- Bachelor's degree required, or five (5) years of relevant leadership experience in lieu of a Bachelor's degree.
- Ten (10) years of experience in Finance or Revenue Cycle.
OUR PURPOSE & VALUES:
Our mission is to provide exceptional healthcare services in a safe and trustful environment through expertise, commitment and compassion of our team members, with the vision of safe, reliable, high quality care for each patient, every day.
How do we make this happen? By creating and maintaining a culture where our values of compassion, integrity, citizenship, service excellence and community are lived out in observable behaviors during all interactions.
ABOUT CENTRAL MAINE HEALTHCARE:
Central Maine Healthcare (CMH) is an integrated healthcare delivery system serving 400,000 people living in central, western, and mid-coast Maine. CMH's hospital facilities include Central Maine Medical Center in Lewiston, Bridgton Hospital, and Rumford Hospital. CMH also supports Central Maine Medical Group, a primary and specialty care practice organization. Other system services include the Central Maine Heart and Vascular Institute, a regional trauma program, LifeFlight of Maine's southern Maine base, the Central Maine Comprehensive Cancer Center, and other high quality clinical services.
About Central Maine Medical Center
Central Maine Medical Center (CMMC) located in Lewiston, is a Level II Trauma Center serving Androscoggin County and the surrounding region. "CMMC's Centers of Excellence" include the Central Maine Heart and Vascular Institute, the Central Maine Comprehensive Cancer Center, the Neonatal Intermediate Care Unit, and a Trauma Services Program. CMMC is also the southern Maine base for LifeFlight of Maine, the state's only medical helicopter service. Supported by the latest technologies, CMMC's skilled professionals provide outstanding care delivered with compassion, kindness, and understanding. Learn more at: www.cmmc.org.
About Bridgton Hospital
Part of Central Maine Healthcare, Bridgton Hospital serves the town of Bridgton and surrounding areas in Maine as part of an integrated regional healthcare system committed to improved access and a uniform standard of care. Bridgton Hospital was named as one of 17 top rural hospitals in the nation for the third consecutive year in 2018.
About Rumford Hospital
Part of Central Maine Healthcare, Rumford Hospital serves the town of Rumford and surrounding areas in Maine as part of an integrated regional healthcare system committed to improved access and a uniform standard of care. In 2018, Rumford Hospital was named one of 17 top rural hospitals in the nation by the Leapfrog Group; in 2016, it was designated a Pathway to Excellence® organization by the American Nurses Credentialing Center. Learn more at: www.rumfordhospital.org.
Central Maine Healthcare is equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law.
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