Manager of Revenue Integrity

Overview

Central Maine Healthcare (CMH), a member of Prime Healthcare Foundation, is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine through a network of more than 40 primary and specialty care locations. The system includes Central Maine Medical Center (CMMC) in Lewiston, a 250-bed, not-for-profit regional referral hospital that is home to the region's only Cancer Care Center, an orthopedic ambulatory surgery center, and the Central Maine Heart and Vascular Institute.

CMMC also serves as the central Maine base for Life Flight of Maine, the state's only medical helicopter service.

Central Maine Healthcare (CMH), a member of Prime Healthcare Foundation, is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine through a network of more than 40 primary and specialty care locations. The system includes Central Maine Medical Center (CMMC) in Lewiston, a 250-bed, not-for-profit regional referral hospital that is home to the region's only Cancer Care Center, an orthopedic ambulatory surgery center, and the Central Maine Heart and Vascular Institute.

CMMC also serves as the central Maine base for Life Flight of Maine, the state's only medical helicopter service.

CMH also includes Bridgton Hospital and Rumford Hospital, two 25-bed critical access hospitals that provide essential care to Maine's rural communities.

As part of its commitment to healthcare education and workforce development, CMH is home to the Maine College of Health Professions, Maine's first nursing and medical imaging school. The private, not-for-profit institution is accredited by the New England Commission of Higher Education and plays an important role in training the next generation of healthcare professionals.

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The Manager Revenue Integrity is responsible for operational leadership of the Revenue Integrity department. This position contributes to the financial strength, compliance and overall performance of Revenue Cycle operations by providing leadership for all Revenue Integrity functions, including hospital and physician (provider) services. The Manager also provides assistance to the Sr. Director Revenue Integrity. The Manager Revenue Integrity serves in a key role to monitor and facilitate improvement in the overall quality, timeliness, completeness, and accuracy of Revenue Integrity processes (such as charge master maintenance, charge compliance and accuracy, payment variance analytics and prevention and overall quality and accuracy of all data flowing through the revenue cycle).

Data integrity and reporting of financial performance and impact of improvement initiatives and standard KPIs is required. The Manager will ensure the effectiveness of Revenue Integrity policy, practices and technology platforms. Net revenue/performance improvement goal setting, monitoring and achievement are required.

The position will provide leadership, coordination, and evaluation of Revenue Integrity and is specifically responsible for the following:

• Charge Master Maintenance and Accuracy
• Charge Capture Completeness, Accuracy and Reconciliation
• Payment Variance Analytics, Reporting and Prevention
• Regulatory Adherence across Revenue Cycle departments and organizationally
• Provider Based Status and Facility Enrollment
• Assisting the Senior Director in building and maintaining Revenue Cycle reporting & analytics
• Financial Improvement Goal Setting, Process Improvement, Tracking and Reporting
• Data Trending
• KPI and Operational Dashboards and Reports
• Supporting Organizational Dashboards and Reports
• Vendor Management
• Revenue Informatics…