Senior Director, Revenue Integrity

Banner Health • Phoenix, AZ

23d

About The Position

Help lead health care into the future. As one of the largest nonprofit health systems in the country, Banner Health has both the stability that comes with success and the values you can be proud to represent. If you’re looking to leverage your abilities – you belong at Banner Health. Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits. In addition, this position may be eligible for our Management Incentive Program as part of your Total Rewards package. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position is responsible for development and long term sustainability of compliant charge capture workflows for clinician driven revenue. Responsible for documentation, audit and system driven revenue capture. Highest level of escalation for issues related to charge capture operations. This position is responsible for creation and maintenance of a quality assurance funciton to complete a provider education, review and feedback loop to preserve revenue integrity with charge entry and clinical staff. Responsible for ongoing monitoring of regulatory changes impacting revenue cycle. This postion is responsible for project coordination to implement required regulatory changes specific to revenue cycle. Leadership of charge auditing functions generating revenue recoveries in acute and ambulatory service lines.

Requirements

• Bachelor’s Degree in a relevant field or equivalent level of education and experience.
• Expert-level working knowledge of principles, practices, and operations in assigned or related area of responsibility as normally obtained through a minimum of ten plus years of progressively responsible managerial experience within a healthcare system setting or large multi-operational, complex corporate environment.
• Working knowledge of regulatory, compliance and legal requirements pertaining to revenue cycle, charge capture and revenue integrity.
• Revenue cycle experience, preferrably from middle revenue cycle disciplines.
• Depending upon assigned area of responsibility, position may require applicable certifications and/or licensures, including but not limited to: RN; MD or DO; Driver’s License; Certified Healthcare Protection Administrator (CHPA); Certified Protection Professional (CPP); Chartered Property Casualty Underwriter (CPCU); Associate in Risk Management (ARM); CPA; SPHR; Registered Health Information Administrator (RHIA); Registered Health Information Technologist (RHIT); Certified Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an American Bar Association accredited school; admission to a State Bar Association.
• Must demonstrate expert-level knowledge and awareness of area of expertise in designated facility, business entity or area and/or experience in which the knowledge, skills, and abilities are directly transferrable.
• Proven track record of driving successful performance outcomes and accomplishing organizational goals.
• Must demonstrate skills and business acumen through direct leadership experiences such as: Anticipating and responding to the needs of internal and external customers; managing a budget and financial plans; building partnerships with management, staff, and stakeholders to achieve department goals and objectives; managing problems and situations where uncertainty is inherent; persuading others to adopt a particular stance on an issue; developing and evaluating best practices and emerging trends for organizational applicability and appropriateness; constructing new and innovative solutions for complex and varying problems and situations while considering the larger perspective or context; mentoring and coaching staff by providing open and honest feedback to enhance performance; developing and implementing strategic goals and initiatives that support organizational success; demonstrating excellent human relations, organizational and communication skills; demonstrating a passion about continuously improving and providing high quality care and service excellence to customers, patients, families, employees and/or physicians.

Nice To Haves

• Nursing degree, coding certification, CRCR, RHIT, Healthcare Management or similar certification is preferred.
• Additional related education and/or experience preferred.

Responsibilities

• Guides the development and implementation of goals and objectives for various revenue integrity programs and processes (such as charge capture, compliance, Charge Description Master, denials management). Incorporates best practices and responds to emerging trends to enhance operations, programs, and/or services. Implements and evaluates revenue integrity programs, develops effective tools to measure performance, analyzes related data, prepares reports, and makes recommendations to senior leadership based on findings.
• Directs, supervises, and evaluates the work of staff and managers. Holds staff accountable for achieving plans and performance targets. Ensures appropriate staffing and coverage for the System regarding Revenue Integrity functions. Works with staff to identify and resolve the most complex revenue integrity related issues and problems. Supports development and continued professional growth to meet company and individual goals for long-term success. Demonstrates an expectation for continuous quality improvement utilizing processes that include consideration of all stakeholders.
• Builds and supports effective relationships with internal and external stakeholders and organizations. Develops partnerships, coordinates activities, reviews work, exchanges information, and/or resolves problems related to Revenue Integrity.
• Directs and participates in the development, implementation, and consistent application of effective organizational policies, procedures, and practices. Develops and supports internal controls to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective and efficient, and compliance with current laws and regulations is achieved.
• Develops and oversees the department budget to meet corporate goals and objectives. Meets annual budgetary goals. Translates organizational plans, goals, and initiatives into applicable financial related targets. Negotiates contracts with external vendors for products and/or services and monitors/evaluates quality and/or performance. Manages and reports expenditures.
• Communicates the department vision, translating it into actionable projects and activities. Maximizes management staff’s contributions and assures timely decision-making reflecting the mission, vision, and values of the system.
• Reviews, prepares, analyzes, and presents reports and recommendations to senior leadership regarding operations, programs, services, and/or other applicable areas of interest in order to provide concise and accurate information that aids in decision-making.
• Participates as a subject-matter expert and may lead or facilitate task forces, teams, and/or councils to plan, implement and coordinate programs, services, and/or activities for the organization. May serve as a staff resource to the organization’s Governing Board and/or applicable committees.
• This position has direct leadership accountability for decision making and support to help ensure the continued financial stability of the organization and achievement of performance metrics. This position requires the skill to negotiate and influence. Customers of this position are both internal and external, including leadership, staff, medical staff, regulatory agencies, and/or the community.

What This Job Offers

• Job Type: Full-time
• Career Level: Director