System Director – Revenue Integrity

This is a fully remote position, open to applicants in California, +9 more states.

📋 Description

• Design and implement the enterprise Revenue Integrity strategy, operational model, and a multi-year plan for the health system.

• Create standardized policies, procedures, controls, and governance for Revenue Integrity across hospitals and business units.

• Establish accountability for charge capture, charge reconciliation, chargemaster maintenance, documentation, coding, and revenue-related operational processes.

• Provide guidance to senior leadership regarding compliance risks, revenue opportunities, operational performance, and strategic priorities.

• Lead the development and enhancement of the organizational structure for enterprise Revenue Integrity.

• Supervise charge capture across hospitals, professional services, ambulatory care, procedures, diagnostics, pharmacy, supplies, implants, and ancillary services.

• Create processes for charge reconciliation and prevention of revenue leakage.

• Exercise executive oversight of hospital chargemasters, professional fee schedules, charging dictionaries, and associated reference files.

• Develop and maintain enterprise CDM standards along with formal change-management processes.

• Lead audit and monitoring initiatives for enterprise Revenue Integrity.

• Identify and resolve issues related to missing charges, incorrect charges, coding discrepancies, documentation inadequacies, billing errors, payer concerns, and reimbursement variances.

• Monitor updates in regulatory, coding, reimbursement, and commercial payer policies and operationalize necessary changes.

• Integrate Revenue Integrity with Coding, Clinical Documentation Integrity, Billing, Denials, Contracting, and Compliance functions.

• Collaborate with clinical and operational leaders to enhance point-of-care charge capture.

• Formulate service-line-specific Revenue Integrity strategies for high-risk and high-value sectors.

• Provide leadership for Revenue Integrity during EHR implementations, conversions, upgrades, and optimization efforts.

• Oversee charge workflows, charge routers, automated charging, interfaces, preference lists, order-to-charge, supply, pharmacy, and professional charge capture needs.

• Develop frameworks for enterprise performance, dashboards, KPIs, departmental scorecards, and accountability mechanisms.

• Monitor recovered revenue, prevented leakage, process enhancements, and risk mitigation strategies.

• Recruit, develop, and retain leadership and technical teams within Revenue Integrity.

• Establish roles, competency standards, career pathways, succession planning, and educational programs.

⛳️ Requirements

• Must be a resident of one of the following states: Arkansas, California, Kentucky, Massachusetts, Nevada, New Mexico, Oregon, Utah, Tennessee, Texas, or Wyoming.

• Proven experience and expertise in enterprise Revenue Integrity leadership.

• In-depth knowledge of charge capture, chargemaster governance, revenue assurance, compliance, clinical revenue cycle integration, revenue leakage prevention, reimbursement compliance, and Revenue Integrity performance.

• Experience collaborating with Finance, Revenue Cycle, Clinical Operations, Coding/HIM, Compliance, Information Technology, Supply Chain, Pharmacy, and hospital leadership.

• Familiarity with CPT and HCPCS assignments, revenue codes, modifiers, pricing, charge descriptions, charge logic, and billing configuration.

• Understanding of CMS, state regulations, AMA coding, and commercial payer requirements.

• Experience with EHR and revenue cycle systems, charge workflows, charge routers, automated charging, interfaces, preference lists, order-to-charge logic, supply charging, pharmacy charging, and professional charge capture.

• Proven track record in developing analytics, executive dashboards, KPIs, scorecards, audit programs, corrective actions, and performance management frameworks.

• Experience in recruiting, developing, and retaining leadership and technical teams in Revenue Integrity.

🏝️ Benefits

• Full-time remote work arrangement.

• Opportunities for professional development and relevant certification.