Manager, Revenue Integrity

Trinity Health

1d•$25 - $32

About The Position

Provides support and day-to-day operational management for Medical Group and Provider Services (MGPS) revenue cycle operations, including registration, insurance verification, point-of-service collections, authorizations, charge capture and controls, revenue integrity and optimization, coding, and general practice revenue cycle operations. May oversee payer enrollment, credentialing, and other practice-related functions. Leads operational excellence through centralized oversight and management of regional revenue cycle practices, promoting standardization and implementation and use of top-decile practices. Serves as a key change leader. Works closely with Regional CFOs, Patient Business Service (PBS) center, C-Suite, Payer Strategies, MGPS Practice Leaders, Hospital Site Operations leaders, and colleagues across the organization. Reports to a Regional Director or Director of MGPS Site Operations, or has an A2 relationship to both the Vice President of MGPS Revenue Cycle Site Operations and the Regional or Local Finance Leader. The role manages regional revenue cycle operations, people, budgets, best-practice implementation, training, performance improvement, and professional Revenue Integrity functions. It is accountable for key revenue cycle outcomes in collaboration with regional and system leadership. The position operates in a typical office environment, requires frequent communication, and may involve travel of approximately 25% within the region and to other MGPS locations or the System Office. Varied or extended hours may be required as workload and priorities change.

Requirements

Bachelor’s degree in business, healthcare administration, or a related field, or an equivalent combination of education and experience.
Five to seven years of experience in revenue cycle operations, revenue metrics and analytics, and revenue management, or equivalent education and experience.
At least three years of management experience in a multifacility integrated healthcare delivery system, revenue cycle, or consulting.
Comprehensive knowledge of physician practice revenue cycle operations, revenue metrics and analytics, and revenue management.
Knowledge of revenue cycle and accounting systems, insurance issues, healthcare industry issues and trends, relevant legal issues, third-party and governmental guidelines, and work processing.
Strong leadership, integration, execution, planning, and strategy skills, including the ability to define objectives and scope and identify operational opportunities, risks, business needs, and stakeholder interests.
Advanced analytical, evaluative, problem-solving, and decision-making skills, including the ability to develop strategies without established guidelines and manage multiple critical assignments.
Excellent written and verbal communication skills, including the ability to assess and facilitate improvements and present recommendations to all levels.
Proficiency with Microsoft Office, including Outlook, Word, PowerPoint, and Excel.
Ongoing professional development through relevant education, an annual development plan, and participation in healthcare revenue activities.
Strong organizational and collaborative leadership skills, including the ability to lead direct and dotted-line reporting relationships and bridge disciplines.
Ability to travel approximately 25% as needed.
Comfort operating in a collaborative, shared-leadership environment.
Ability to inspire and motivate others while exemplifying honesty, integrity, caring, and Trinity Health’s mission, vision, goals, and values.
Ability to concentrate, meet deadlines, handle several projects simultaneously, adapt to interruptions and changing priorities, and work in a fast-paced environment that may be stressful.
Ability to communicate frequently in person and by telephone; manual dexterity to operate a keyboard and hearing adequate for extensive telephone and in-person communication.
Ability to comply with Trinity Health policies and procedures.

Nice To Haves

Epic experience is strongly preferred.

Responsibilities

Demonstrate Trinity Health’s Mission, Vision, and Values in behaviors, practices, and decisions.
Manage regional Medical Group revenue cycle operations and implement system and local goals to promote standard, top-decile operations.
Implement current and future revenue cycle best practices, monitor adherence to payer contracts and procedures, and use system resources to improve outcomes.
Partner with senior leadership at RHMs, MGPS Finance, Payer Strategies, and PBS to develop and implement action plans that improve front-end revenue cycle processes affecting billing, collections, and account resolution.
Select, direct, and develop team members; conduct performance appraisals for team leadership; cascade team goals; and foster motivation, teamwork, accountability, and colleague retention.
Facilitate process and technology training to build technical proficiency, efficiency, regulatory compliance, and customer service.
Manage regional budgets and targets and provide financial oversight of regional revenue cycle functions.
Collaborate with MGPS senior leadership, Finance, Practice and PBS leaders, regional directors, clinical leadership, and colleagues on performance goals, A-3 projects, strategic initiatives, and improvement opportunities across people, process, and technology.
Collaborate with Hospital Site Operations, the Vice President of MGPS Revenue Cycle Site Operations, and the Regional or Local Finance Leader to direct local Revenue Cycle and oversee professional Revenue Integrity functions, including the Charge Description Master, assigned pre-bill edits, complex coordination, and denial prevention.
Account for revenue cycle outcomes, including financial secure rate, authorization rate, upfront collections, denial rate, colleague quality and productivity, colleague engagement and satisfaction, patient engagement and satisfaction, and fiscal-year budget targets.
Maintain working knowledge of applicable laws, regulations, compliance requirements, codes of conduct, policies, and procedures.
Maintain professional development through continuing education, an annual development plan, professional affiliations, and participation in local, regional, and national healthcare revenue activities.
Recruit, retain, manage, train, and mentor staff; foster teamwork between business and clinical stakeholders.
Lead direct and dotted-line reporting relationships and work effectively in a collaborative, shared-leadership environment.
Travel approximately 25% as needed within the region, including to MGPS locations outside the region and the System Office.