Manager Revenue Integrity and Analytics
Manager Revenue Integrity and Analytics
As the Manager Revenue Integrity and Analytics plays you will play a crucial role in maximizing the financial performance of the organization by developing and implementing effective revenue management strategies. You will provide leadership and direction to teams monitoring and auditing the accuracy of coding and billing processes. Act as a liaison for hospital departments and physician groups to ensure compliance with billing and reimbursement contracts. This position involves analyzing market trends, forecasting demand, and optimizing pricing strategies to enhance profitability. Our ideal candidate will possess a strong analytical mindset and the ability to work collaboratively across departments to drive revenue growth.
Our ideal candidate will have strong analytical skills with the ability to interpret complex data sets. High proficiency in revenue management systems and tools. Excellent communication skills for effective collaboration across departments.
Detail-oriented with a focus on accuracy in reporting and analysis. The ability to think strategically while managing day-to-day operational tasks. Experience in forecasting, budgeting, and financial analysis is preferred. Strong problem-solving skills with a proactive approach to identifying opportunities for improvement. Knowledge of industry standards and best practices in revenue management.
This position is vital for driving the financial success of the organization through strategic planning and execution. If you are passionate about maximizing revenue potential and have a keen eye for detail, we encourage you to apply.
What you will do:
- Provide leadership in researching and implementing best practice for patient-friendly financial interactions
- Direct and supervise assigned personnel in their day-to-day tasks including scheduling, orientation and training for new staff, assigns Work queues assignments and monitors productivity and quality
- Assist in the analysis and monitors the charge master structure and charging practices to ensure system wide compliance with federal, state, and local regulations for charge codes and related information in the CDM
- Act as subject matter expert on current federal, state, and local charging guidelines, coding and billing requirements
Reviews all assigned edits and denials within prescribed timeframe and routes to appropriate owner for resolution working closely with the Revenue Cycle teams to trend from the root cause - Supervise the regulatory coding and billing support to Clinical Charge Capture Specialists (CCCS) to address Charge Description Master (CDM), coding, charge capture and billing questions
- Perform modeling and analysis in the build of organization-wide pricing strategy processes, analysis for missing charge capture and pricing as necessary
- Supervise department-specific review of capture analysis and provides feedback to clinical department management
- Assist in the research for the financial impact of annual CMS regulatory changes
- Knowledgeable of payer strategies based on third party publications, including Blue
- Shield, Medicare, Medicaid, commercial insurers and HMOs/PPOs
- Collaborate with departments for charge capture and reimbursement issues, provides and/or assigns education, and assists with remediation
What you will bring:
- Requirements and Minimum Qualifications
- Bachelor's degree required; relevant certification and 5 years related experience may be accepted in lieu of a bachelor's degree
- Continuing education and certification following hire strongly encouraged
- Minimum 5 years' healthcare financial experience required
- 2 year's revenue integrity experience preferred
- Previous financial healthcare experience required with healthcare analytics and/or financial decision support preferred
- Previous lead or supervisor experience preferred
- Strong analytical and problem-solving skills; able to perform independently, using sound judgment and SQL queries
- Demonstrated knowledge of gross and net revenue impact of pricing strategies
- Experience with commercial and government billing, and reimbursement methodologies
Our Ideal candidate will have strong analytical skills with the ability to interpret complex data sets. High proficiency in revenue management systems and tools. Excellent communication skills for effective collaboration across departments.
Detail-oriented with a focus on accuracy in reporting and analysis.Ability to think strategically while managing day-to-day operational tasks.Experience in forecasting, budgeting, and financial analysis is preferred.Strong problem-solving skills with a proactive approach to identifying opportunities for improvement. Knowledge of industry standards and best practices in revenue management.
This position is vital for driving the financial success of the organization through strategic planning and execution. If you are passionate about maximizing revenue potential and have a keen eye for detail, we encourage you to apply.
Working Conditions:
• Must be able to maintain a sitting position
• Typical equipment used in an office job
• Repetitive movements
About Kootenai Health:
Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider.
As your next employer, we are excited to offer you:
- Kootenai Health offers comprehensive medical plan options, including options for fully paid employer premiums for our full-time employees. For part-time employees, we offer the same plan options with affordable part-time premiums. In addition to medical insurance, we offer many voluntary benefits ranging from dental and vision to life and pet insurance. Kootenai Health also offers well-being resources and telemedicine service options to all employees, regardless of benefit eligibility. Benefits begin on the 1st of the month following 30 days of employment.
- Kootenai Health's tuition assistance program is available after 90 days. If you want to further your education, we'll help you pay for it
- Kootenai Health sponsors retirement plans for employees that enable you to save money on a pre-tax and Roth after tax basis for your retirement. Kootenai Health will match your contributions based on years of service ranging from 3-6 percent.
- Competitive salaries with night, weekend, and PRN shift differentials
- An award-winning and incentive-driven wellness program. Including a MyHealth corporate team, onsite financial seminars, and coaching
- Employees receive discounts at The Wellness Bar, PEAK Fitness, and more
- Robust and interactive employee referral program
- And much more
Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you!
Apply today! Please contact the HR Front Desk at 208-625-4620 or email Lindsay Buchanan at lbuchanan@kh.org with any questions.
Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.