Revenue Integrity Manager

MaineGeneral Health • Waterville, ME

3d

About The Position

MaineGeneral Health is seeking an experienced and strategic Revenue Integrity Manager to lead departmental operations and oversee initiatives that support accurate reimbursement, revenue optimization, and organizational financial performance. The role develops and implements strategies to strengthen revenue integrity, improve financial processes, and ensure compliance with regulatory requirements and payer guidelines. It works collaboratively with clinical, financial, and administrative leaders and oversees charge capture, Charge Description Master (CDM) maintenance, billing and reimbursement analysis, and other revenue optimization initiatives.

The Revenue Integrity Manager leads daily departmental operations; establishes goals, performance standards, and improvement initiatives; and directs programs and strategies designed to improve reimbursement accuracy and organizational financial health. The role monitors performance metrics, payment variances, reimbursement trends, and revenue risks; ensures compliant operations; supervises and develops staff; manages budgets, vendor relationships, and resource allocation; and collaborates across departments on sustainable improvements and strategic initiatives.

Requirements

• Experience in healthcare revenue cycle management, revenue integrity, reimbursement, or healthcare financial operations.
• Demonstrated leadership experience, including staff supervision, performance management, and team development.
• Strong understanding of healthcare reimbursement methodologies, payer requirements, billing processes, and regulatory compliance.
• Knowledge of charge capture processes, Charge Description Master (CDM) maintenance, and revenue integrity practices.
• Experience analyzing financial data, payment variances, reimbursement trends, and operational performance metrics.
• Strong financial management skills, including budgeting, resource allocation, and expense oversight.
• Ability to develop and implement operational strategies, performance improvement initiatives, and sustainable process improvements.
• Excellent analytical, problem-solving, and decision-making skills.
• Strong communication and relationship-building skills, including the ability to collaborate across clinical, financial, and administrative teams.
• Ability to manage multiple priorities, lead complex initiatives, and drive results in a dynamic healthcare environment.

Responsibilities

• Lead daily operations of the Revenue Integrity department in alignment with departmental goals and organizational objectives.
• Partner with leadership to establish departmental goals, performance standards, operational strategies, and long-term improvement initiatives.
• Direct revenue integrity programs and financial optimization strategies to improve reimbursement accuracy, maximize revenue, and support organizational financial health.
• Establish performance benchmarks, monitor key performance indicators, and use data analytics to identify trends and improvement opportunities.
• Oversee charge capture integrity, Charge Description Master (CDM) maintenance, and billing and reimbursement analysis.
• Monitor payment variances, reimbursement trends, and potential revenue risks; develop strategies to address discrepancies and improve financial outcomes.
• Ensure revenue integrity processes comply with regulatory requirements, payer guidelines, contractual agreements, and organizational policies.
• Oversee staff management and development, including recruitment, performance evaluations, scheduling, payroll, employee engagement, and conflict resolution.
• Promote a positive and productive team environment that encourages professional development, accountability, and employee satisfaction.
• Manage departmental budgets, vendor relationships, and resource allocation.
• Evaluate equipment, staffing, and resource needs; develop recommendations and justify capital and operational expenditures as appropriate.
• Collaborate with clinical, financial, and administrative departments to strengthen revenue processes, improve communication, and implement sustainable solutions.
• Lead special projects, organizational initiatives, and strategic programs as assigned by leadership.
• Use data analytics, payer requirements, and industry standards to identify revenue improvement opportunities and strengthen organizational compliance.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• Wellness programs and resources
• Leave for new parents
• Generous earned time plan
• Employee Assistance Program
• Payactiv access to wages earned before payday
• Tuition reimbursement
• 403(b) company-matching contributions of up to 2% of eligible pay for eligible employees
• 401(a) retirement income plan with another 2% contribution
• Life insurance
• Short-term disability insurance
• Long-term disability insurance
• Leadership-supported career development programs and learning and development resources

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed