Director of Revenue Cycle Integration

Hackensack Meridian Health•Hackensack, NJ

About The Position

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Director of Revenue Integration provides strategic leadership and operational oversight for key functions that support and optimize the health network's revenue cycle. This role is responsible for directing the teams and initiatives related to Revenue Cycle Project Management, system-wide Process Improvement, the Revenue Protection Task Force, Contract Variance and Analytics, Revenue Cycle Informatics, and the resolution of Insurance Credit Balances. The Director of Revenue Integration will champion the use of technology, data, and collaborative partnerships to enhance revenue realization, drive operational efficiency, and ensure financial integrity across the organization. This leader will serve as a critical link between Revenue Cycle Operations, Digital Technology Services (DTS), Finance, and Clinical Operations to ensure all systems and processes are aligned with strategic financial goals.

Requirements

Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.
Minimum of 7-10 years of progressive experience in healthcare revenue cycle management, with a deep understanding of both hospital and professional billing.
Minimum of 3-5 years in a leadership or management role, with demonstrated success in leading teams and managing complex projects.
Expert-level knowledge of end-to-end revenue cycle processes, including patient access, charge capture, coding, claims submission, payment posting, denial management, and contract variance.
Proven experience with major EMR/EHR systems, with a strong preference for extensive EPIC experience (Resolute HB/PB, Cadence, Prelude).
Strong strategic thinking, problem-solving, and analytical skills with the ability to interpret complex data and formulate data-driven business strategies.
Exceptional communication, presentation, and interpersonal skills, with the ability to influence and collaborate effectively with senior executives, physicians, and staff at all levels.
Demonstrated success in leading large-scale change management and process improvement initiatives.
Excellent written and verbal communication skills.
Proficient computer skills that include but are not limited to Google Suite and/or Microsoft Office platforms.

Nice To Haves

Master's Degree in Business Administration (MBA) or Healthcare Administration (MHA).
Advanced EPIC Revenue Cycle certifications (e.g., Resolute Hospital Billing, Resolute Professional Billing, Prelude, Cadence).
Certification from the Healthcare Financial Management Association (HFMA), such as Certified Healthcare Financial Professional (CHFP) or Fellow of the Healthcare Financial Management Association (FHFMA).
Experience with data visualization tools (e.g., Tableau, Power BI).
EPIC Resolute Hospital Billing/Professional Billing, Prelude/Cadence, or other relevant Epic Revenue Cycle certifications.

Responsibilities

Develop and execute a comprehensive, long-term strategy for revenue integration, aligning departmental goals with the organization's financial objectives.
Provide direct leadership, mentorship, and professional development to managers and team members within Project Management, Informatics, Contract Analytics, and Credit Balance teams.
Establish, monitor, and report on Key Performance Indicators (KPIs) for all areas of responsibility, driving a culture of accountability and continuous improvement.
Manage departmental budgets, resource allocation, and vendor relationships to ensure efficient and effective operations.
Oversee the entire portfolio of revenue cycle projects, including EPIC system implementations, optimizations, and upgrades, ensuring they are delivered on time, within budget, and meet strategic objectives.
Direct the Revenue Cycle Project Management team, providing guidance on project prioritization, risk mitigation, and stakeholder communication.
Guide the Informatics team to develop and maintain robust reporting, dashboards, and analytics that provide actionable insights into revenue cycle performance.
Ensure that system design, build, and workflows (Prelude, Cadence, Hospital Billing, Professional Billing, etc.) are optimized to support efficient operations and maximize reimbursement.
Lead the cross-functional Revenue Protection Task Force to proactively identify, quantify, and mitigate risks of revenue leakage across the patient access and billing continuum.
Champion end-to-end process improvement initiatives, utilizing methodologies like Lean or Six Sigma to analyze workflows, eliminate waste, and enhance productivity.
Collaborate with operational leaders to implement standardized best-practice workflows and policies that protect and enhance revenue streams.
Direct the Contract Variance and Analytics team to perform systematic analysis of payer reimbursement versus contracted rates, identifying and pursuing underpayments and denial trends.
Direct the Contract Variance and Analytics team to perform systematic analysis of payer reimbursement versus contracted rates, identifying and pursuing underpayments and denial trends.
Translate complex data into clear, concise presentations and recommendations for senior leadership to inform payer strategy and negotiations.
Provide strategic oversight for the Insurance Credit Balance team, ensuring the timely, accurate, and compliant resolution of all outstanding credit balances.
Develop and enforce policies and procedures to minimize the creation of credit balances and ensure adherence to all state and federal regulations (e.g., escheatment).
Serve as the primary liaison between Revenue Cycle leadership and key partners, including DTS, Finance, Compliance, Payor Strategy, and clinical department leaders.
Effectively communicate project status, performance metrics, and strategic initiatives to executive leadership and other stakeholders.
Foster a collaborative environment to ensure seamless integration of new business lines, technologies, and physician practices into the existing revenue cycle infrastructure.
Other duties and/or projects as assigned.
Adheres to HMH Organizational competencies and standards of behavior.