Stanford Health Care
Revenue Integrity Program Manager (Remote)
Stanford Health Care, Sacramento, California, United States, 95828
Revenue Integrity Program Manager (Remote)
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1.0 FTE Full Time Day - 08 Hour R2550961 Remote USA 108610067 Rev Cycle Admin Revenue Integrity Finance & Revenue Cycle
If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.
Day - 08 Hour (United States of America)
This is a Stanford Health Care job.
A Brief Overview
The Revenue Integrity Program Manager is a critical role responsible for optimizing hospital and professional revenue, identifying potential revenue leakage while ensuring compliance in charging and billing practices within the healthcare system. Serving as the primary liaison for Revenue Cycle, this position interfaces directly with clinical departments leaders, Clinical Department Chairs, and School of Medicine Directors of Finance & Administration (DFA).
Through a combination of data analytics, and process improvement techniques, this role will support the accurate capture of charges, identify meaningful opportunities to improve, and work closely with physician leadership and partnering with Compliance to provide education and training. This position will also provide ongoing communication through reports & regular presentations as well as handling intake of requests and potential improvement opportunities. Prepares and leads the monthly Revenue Integrity and the School of Medicine DFA meetings for professional revenue cycle.
Locations
Stanford Health Care
What You Will Do
Charging Optimization: Conducts prospective and retrospective reviews/audits of charge capture practices in the clinical departments. Reports findings, provides education to both Providers and charge capture support staff. Coordinates charge capture improvement tools in collaboration with Revenue Cycle TDS IT teams. Reports potential compliance issues for further analysis and follow-up to the Compliance Department.
CDM Optimization: Works to ensure a compliant and consistent system CDM. Works with existing tools to evaluate CDM requests with a focus on regulatory coding, compliance, and adherence to SHC internal guidelines regarding CDM maintenance, standard naming conventions and pricing integrity.
Department Education: In collaboration with the Compliance Department, provides education to clinical department staff regarding CPT codes, HCPCS codes, revenue codes and modifiers and their compliance use.
Project Management: Leads projects to improve revenue capture, increase efficiencies in the charge capture process, and reduce provider burden with the charging process.
Financial Analysis: Performs basic financial analyses to report the impact of charge capture practice changes and corrections to current practices. Communicates findings fully with clinical departments and executive team.
Issue Resolution: Through the combination of EPIC WQs, external edit platforms, and ongoing evaluation, identifies charging issues and works to identify solutions.
Performance Review: Provides ongoing reporting of revenue performance to a variety of audiences including Chairs, Faculty, DFA’s, Division and Clinic Chiefs, Executive Director, Mid-Revenue Cycle, the Director of Revenue Integrity and others as appropriate. Responsible to present confidently to a wide range of individuals across the organization.
Education & Experience Qualifications
Bachelor's degree in a work-related discipline/field from an accredited college or university (or equivalent combination of education/experience)
Five (5) years of progressively responsible directly related work experience
Required Knowledge, Skills And Abilities
Proficient in hospital and professional revenue cycle operations.
Expert in analyzing revenue data to identify trends and opportunities with the capacity to communicate findings effectively to varied audiences. Ability to analyze revenue data and identify trends and opportunities and the ability to present such data to a variety of audiences
Strong Interpersonal skills facilitating seamless communication with clinical staff, and faculty. hat allow ease of communication with Clinical staff and faculty
Solid understanding of coding conventions and current third-party payer rules and regulations Knowledge of coding conventions
Current knowledge of third party payer rules and regulations
Knowledge of computer systems, specifically, Epic Care and related interfaces
Knowledge of management and supervision and the ability to organize staff’s work
Strong written and verbal communication skills to articulate analyses and finding to Chairs, DFAs and Clinical Operations leadership. Ability to write, and speak to the analyses performed
Proven Ability to provide leadership skills in problem identification and issue resolution
Ability to influence decision-making through persuasive data-supported arguments. Ability to change the course of events through convincing arguments supported by data
Ability to apply critical thinking skills to complex issues and situations
Competence in mediating and solving intricate work problems. Ability to mediate and solve complex work problems and issues
Ability to effectively facilitate work groups towards to successful outcomes
Ability to facilitate stakeholder meetings, including agenda development, discussion, documentation, action item follow-up and presentation development.
Strong organizational skills and attention to detail, with the ability to manage multiple priorities effectively.
Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.
Base Pay Scale Generally starting at $66.52 - $88.14 per hour
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1.0 FTE Full Time Day - 08 Hour R2550961 Remote USA 108610067 Rev Cycle Admin Revenue Integrity Finance & Revenue Cycle
If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.
Day - 08 Hour (United States of America)
This is a Stanford Health Care job.
A Brief Overview
The Revenue Integrity Program Manager is a critical role responsible for optimizing hospital and professional revenue, identifying potential revenue leakage while ensuring compliance in charging and billing practices within the healthcare system. Serving as the primary liaison for Revenue Cycle, this position interfaces directly with clinical departments leaders, Clinical Department Chairs, and School of Medicine Directors of Finance & Administration (DFA).
Through a combination of data analytics, and process improvement techniques, this role will support the accurate capture of charges, identify meaningful opportunities to improve, and work closely with physician leadership and partnering with Compliance to provide education and training. This position will also provide ongoing communication through reports & regular presentations as well as handling intake of requests and potential improvement opportunities. Prepares and leads the monthly Revenue Integrity and the School of Medicine DFA meetings for professional revenue cycle.
Locations
Stanford Health Care
What You Will Do
Charging Optimization: Conducts prospective and retrospective reviews/audits of charge capture practices in the clinical departments. Reports findings, provides education to both Providers and charge capture support staff. Coordinates charge capture improvement tools in collaboration with Revenue Cycle TDS IT teams. Reports potential compliance issues for further analysis and follow-up to the Compliance Department.
CDM Optimization: Works to ensure a compliant and consistent system CDM. Works with existing tools to evaluate CDM requests with a focus on regulatory coding, compliance, and adherence to SHC internal guidelines regarding CDM maintenance, standard naming conventions and pricing integrity.
Department Education: In collaboration with the Compliance Department, provides education to clinical department staff regarding CPT codes, HCPCS codes, revenue codes and modifiers and their compliance use.
Project Management: Leads projects to improve revenue capture, increase efficiencies in the charge capture process, and reduce provider burden with the charging process.
Financial Analysis: Performs basic financial analyses to report the impact of charge capture practice changes and corrections to current practices. Communicates findings fully with clinical departments and executive team.
Issue Resolution: Through the combination of EPIC WQs, external edit platforms, and ongoing evaluation, identifies charging issues and works to identify solutions.
Performance Review: Provides ongoing reporting of revenue performance to a variety of audiences including Chairs, Faculty, DFA’s, Division and Clinic Chiefs, Executive Director, Mid-Revenue Cycle, the Director of Revenue Integrity and others as appropriate. Responsible to present confidently to a wide range of individuals across the organization.
Education & Experience Qualifications
Bachelor's degree in a work-related discipline/field from an accredited college or university (or equivalent combination of education/experience)
Five (5) years of progressively responsible directly related work experience
Required Knowledge, Skills And Abilities
Proficient in hospital and professional revenue cycle operations.
Expert in analyzing revenue data to identify trends and opportunities with the capacity to communicate findings effectively to varied audiences. Ability to analyze revenue data and identify trends and opportunities and the ability to present such data to a variety of audiences
Strong Interpersonal skills facilitating seamless communication with clinical staff, and faculty. hat allow ease of communication with Clinical staff and faculty
Solid understanding of coding conventions and current third-party payer rules and regulations Knowledge of coding conventions
Current knowledge of third party payer rules and regulations
Knowledge of computer systems, specifically, Epic Care and related interfaces
Knowledge of management and supervision and the ability to organize staff’s work
Strong written and verbal communication skills to articulate analyses and finding to Chairs, DFAs and Clinical Operations leadership. Ability to write, and speak to the analyses performed
Proven Ability to provide leadership skills in problem identification and issue resolution
Ability to influence decision-making through persuasive data-supported arguments. Ability to change the course of events through convincing arguments supported by data
Ability to apply critical thinking skills to complex issues and situations
Competence in mediating and solving intricate work problems. Ability to mediate and solve complex work problems and issues
Ability to effectively facilitate work groups towards to successful outcomes
Ability to facilitate stakeholder meetings, including agenda development, discussion, documentation, action item follow-up and presentation development.
Strong organizational skills and attention to detail, with the ability to manage multiple priorities effectively.
Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.
Base Pay Scale Generally starting at $66.52 - $88.14 per hour
#J-18808-Ljbffr