Director, Transformation Services – Revenue Integrity

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Lead and oversee Revenue Integrity revenue cycle transformation initiatives for clients.

• Manage project timelines, deliverables, and ensure timely completion of tasks.

• Create reports, presentations, and documentation to assess and communicate the effectiveness of initiatives.

• Enhance tracking tools and establish KPIs and metrics to identify opportunities for operational performance improvement.

• Act as a subject matter expert in Revenue Integrity for both clients and team members.

• Collaborate with colleagues and client partners to tackle business challenges and refine implementation methodologies.

• Monitor analytics and report on trends regarding denials and procedural issues.

• Develop scalable transition strategies to maintain improvements.

• Assist in the development and enhancement of revenue cycle assessment and implementation methodologies.

• Assess current-state operations and formulate transition blueprints aimed at achieving desired future states.

• Set measurable goals and priorities that align with organizational objectives.

• Conduct audits, consolidations, and standardizations of Charge Data Masters and Revenue Integrity workflows.

• Enhance charge capture accuracy through workflow assessments, coding reviews, process enhancements, and report generation.

• Handle, protect, and disclose patients' protected health information in compliance with HIPAA regulations.

• Adhere to Information Security and HIPAA policies and procedures.

• Limit access to protected health information to the minimum necessary level.

⛳️ Requirements

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, or a related field is preferred.

• 7+ years of demonstrated experience in healthcare operations related to revenue integrity, coding, finance, revenue cycle management, patient accounting, and/or physician billing.

• 7+ years of experience in healthcare consulting.

• Proven track record of leading large-scale Revenue Integrity strategic development and implementation projects.

• Comprehensive understanding of charge capture and charge reconciliation processes, including electronic health record charge links to the CDM and charge capture processes.

• Professional certifications such as CPAM or CRCP, or evidence of progress towards such certifications, are advantageous.

• Advanced proficiency in Excel and experience with financial modeling and analysis.

• Strong skills in Microsoft PowerPoint and Word.

• Experience with SQL, SPSS, Power BI, benchmarking, and MGMA survey data is a plus.

• Experience in project leadership and workplan management for opportunity assessments within a consulting environment, particularly in middle revenue cycle areas.

• Knowledge of state and federal governmental, legal, and regulatory requirements related to middle revenue cycle operations.

• Excellent communication and interpersonal abilities.

• Strong analytical and problem-solving skills with a focus on data-driven approaches.

• Ability to thrive in a fast-paced, evolving environment while managing multiple priorities and deadlines.

• Must have a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes.

🏝️ Benefits

• Occasional travel and flexibility to work outside of regular business hours as required.

• Smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes.