[Hiring] Manager- Revenue Integrity @Conifer Health Solutions

Role Description

Oversees professional staff responsible for managing, coordinating, and implementing Charge Description Master (“CDM”) and charge capture initiatives and processes to ensure revenue management and revenue protection. Serving in a senior leadership capacity, has direct interaction and interface with internal and external executive level staff. Facilitates CDM and charge capture education; ensures adherence to government/non-government regulatory directives; ensures appropriate levels of control are established to satisfy audit/review requirements; and facilitates revenue management communications and information flow. Oversees maintenance of accurate and timely patient accounting system(s) changes/updates to sustain data integrity and to facilitate claims processing; ensures quality reviews occur to identify and minimize system errors. Plans revenue management strategies as identified in data/report analyses to ensure consistency/standardization, to identify improvement opportunities, and to facilitate appropriate knowledge transfer. Plans, prepares, and administers annual budget; develops and maintains budgetary controls; balances department needs with Conifer annual budget goals.

Qualifications

• Bachelor’s degree or higher; related experience may be considered in lieu of degree
• Prior supervisory experience required
• Minimum of five years healthcare-related experience required
• Working knowledge of laws and regulations pertaining to healthcare industry required
• Prior healthcare financial experience or related field experience in a hospital/integrated healthcare delivery system required
• Prior CDM or charge capture experience required
• Consulting experience a plus

Requirements

• Strong interpersonal communication and presentation skills, effectively presenting information to executives, management, facility groups, and/or individuals
• Ability to present ideas effectively in formal and informal situations; conveys thoughts clearly and concisely
• Ability to respond in a professional manner to complex inquiries from various levels of personnel
• Accepts personal responsibility for the quality and timeliness of his/her work; establishes due dates for projects and assignments and meets those dates; efficiently organizes activities
• Ability to define problems, collect data, establish facts, draw valid conclusions, and make recommendations for improvement
• Adapts easily to changing conditions and work responsibilities; works well with people of vastly differing levels, styles, and preferences
• Understands external and internal drivers affecting revenue management
• Ability to read, review, analyze, and interpret a variety of state/federal regulatory information and managed care contracts and the affect on appropriate claims production including multiple patient accounting systems, clinical/order entry systems, ancillary systems, and CDM
• Ability to utilize and research various published resources, appropriate reference materials, Internet resources, seminars, and other associated information sources to continually stay abreast of changes in regulatory information
• Working knowledge in MS Office Applications (Excel, Word, Access, Power Point)

Benefits

• Medical, dental, vision, disability, life, and business travel insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrued at a rate of approximately 1.84 hours per 40 hours worked
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance
• For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act

Company Description

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare.