Sr. Director Clinical Revenue Integrity
3 weeks ago
Do not wait to apply after reading this description a high application volume is expected for this opportunity.
Looking to be part of something more meaningful? At HonorHealth, you’ll be part of a team, creating a multi-dimensional care experience for our patients. You’ll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact.
HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more.
Join us. Let’s go beyond expectations and transform healthcare together.
HonorHealth is one of Arizona’s largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 15,000 team members, 3,700 affiliated providers and close to 2,000 volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com.
Qualifications: Education
Bachelor's Degree In Pharmacy from an accredited College of Pharmacy Required
Experience
5 years Pharmacy operations Required
2 years Leadership experience in an acute care setting Required
2 years Epic hospital clinical and billing software Required
Licenses and Certifications
Registered Pharmacist (RPh) Must possess a valid pharmacist licensure in the United States Required
Responsibilities: Job Summary
The Senior Director Revenue Integrity oversees revenue cycle remote workforce and areas closely aligned with clinical operations. The system leader partners and routinely directs the design and delivery of our most complex clinical revenue integrity areas including clinical charge capture accountability, documentation improvement, and payer appeals. By creating collaborative, high performing work environments, optimizing processes and continually addressing revenue leakage, this role is an essential leader in the mid revenue cycle team. Occasional travel to attend continued education, seminars and events.
System responsibility for directing revenue integrity management, strategies, policies and procedures, budget process, project implementations, program expansions and committee representation in designated clinical areas. Ensures the effectiveness of the revenue integrity program, including overall consistency and integration of integrity activities throughout the organization.
Champions and collaborates with acute and hospital outpatient designated areas, Managed Care, Finance, Compliance, and other revenue cycle stakeholders to identify revenue leakage, monitor charge capture activities, oversee payer clinical denials and audits, ensure optimal clean claim rates, and recommend EMR decisions impacting claim submission and reimbursement. This leader will routinely partner with other areas that have an impact on revenue cycle integrity including clinical department leaders, IT, HIM and Utilization Management.
Directs charging and revenue related projects, workflow changes, and engages in the financial assessment during due diligence and return on investment reviews.
Researches and stays current with clinical documentation requirements to support claim submission and payer reimbursement trends. Develops policies, procedures and guidelines related to revenue integrity areas of oversite.
Evaluates areas of revenue integrity opportunity, participates in the strategic decision making and prioritization of those initiatives, monitors outcomes, oversees key performance indicators/metrics and initiates action plans if applicable.
Participates on departmental, hospital, health system and designated clinical committees, actively participates in national, state and regional professional organizations.
Facility: Support Services Department: Revenue Cycle Admin Work Hours: 7am-4:30pm Shift: 01 - Days Position Type: Regular Full-Time
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