Director, Clinical and Revenue Integrity Operations

ABOUT THIS POSITION

The Director, Clinical and Revenue Integrity Operations is responsible for the oversight and management of our team of Revenue Integrity and DRG Auditors. Drawing on clinical and technical expertise, this leader will ensure appropriate staffing, goal setting and performance management of the team.
It is expected that this leader is highly comfortable and highly experienced in engaging with clients and prospects as an expert in their field, and this leader will also be expected to be an integral part of ongoing product and operational strategy. Technical and process aptitude is a must.

WHAT YOU'LL DO

What you'll do:

• Lead several managers focused on driving high revenue leakage findings for our Hospital Charge Integrity and DRG clients
• Support managers with client communication and escalations to ensure smooth resolution
• Grow management team skill set and career path planning
• Inventory processes to ensure efficiency gains and value
• Manage team performance metrics around client commitments
• Analyze data to drive performance and processes improvements
• Monitor internal reports and metrics to facilitate resource allocation to achieve required client and team goals and objectives
• Get hands on with teams, both direct and indirect, to deeply understand processes and provide insightful direction
• Collaborate with cross functional leaders to achieve process clarity and improvement

WHAT YOU'LL NEED

What you'll need:

• High standards for self and others, always striving for the best. Continuously working to drive process and performance.
• Solves problems by analyzing data, identifying root causes and proposing workable solutions.
• A passion to create and communicate a clear team strategy and well-defined action plan
• A high EQ paired with confident leadership in order to garner buy-in and effect change.
• Has the capacity to bring together cross-functional groups to address issues and opportunities.
• Ability to communicate effectively with a wide range of audiences ranging from front-line workers to hospital executives.
• Requires working knowledge of hospital billing practices, payer reimbursement methodology, medical necessity criteria, and applicable industry-based standards
• 15+ years of hospital revenue cycle management
• 5+ years managing audit teams
• Bachelor's degree required
• Relevant industry certifications/memberships (CRCR, RHIA, CPC, etc.) are a plus
• Active use of artificial intelligence (AI) tools and techniques to enhance performance, drive innovation, and improve decision-making across business functions
• Ability to leverage AI tools and platforms to streamline workflows, improve decision-making, and drive innovation
• Curiosity and adaptability in exploring emerging AI technologies, with a mindset for continuous learning and experimentation

ABOUT WAYSTAR

Through a smart platform and better experience, Waystar helps providers simplify healthcare payments and yield powerful results throughout the complete revenue cycle.

Waystar's healthcare payments platform combines innovative, cloud-based technology, robust data, and unparalleled client support to streamline workflows and improve financials so providers can focus on what matters most: their patients and communities. Waystar is trusted by 1M+ providers, 1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid/Medicare payers.  We are deeply committed to living out our organizational values: honesty; kindness; passion; curiosity; fanatical focus; best work, always; making it happen; and joyful, optimistic & fun.

Waystar products have won multiple Best in KLAS or Category Leader awards since 2010 and earned multiple #1 rankings from Black Book surveys since 2012. The Waystar platform supports more than 500,000 providers, 1,000 health systems and hospitals, and 5,000 payers and health plans. For more information, visit  or follow @Waystar on Twitter.  

WAYSTAR PERKS

• Competitive total rewards (base salary + bonus, if applicable)
• Customizable benefits package (3 medical plans with Health Saving Account company match)
• We offer generous paid time off for our non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. We also offer flexible time off for our exempt team members + 13 paid holidays
• Paid parental leave (including maternity + paternity leave)
• Education assistance opportunities and free LinkedIn Learning access
• Free mental health and family planning programs, including adoption assistance and fertility support
• 401(K) program with company match
• Pet insurance
• Employee resource groups

Waystar is proud to be an equal opportunity workplace. We celebrate, value, and support diversity and inclusion. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

---