Multi-Site Manager, Revenue Integrity

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Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. The campus was unveiled in 2019 as WELL-certified, a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams enjoy a welcoming space designed to promote well-being and inspire best work.

Oversees the daily revenue integrity functions that support accurate charging and billing in compliance with state and federal regulations at the facilities within an Adventist Health system. Supports the implementation of system-wide standardization and facilitates long-term strategies to meet expanding and changing needs, in collaboration with operational and clinical leadership. Provides expert advice on charging/reimbursement aspects of growth initiatives. Assists in setting hospital and professional pricing strategies to include maintenance and develops and implements policies for the operations.

Leverages automation for the technical charge description master (CDM) build within Cerner. Assures compliance, manages staff, supports department communication and education for charge capture related matters.

• Education and
  
  Work Experience:
  • Bachelor’s Degree or equivalent combination of education/experience:
    Required
  • Master’s Degree:
    Preferred
  • Five years' healthcare revenue cycle experience:
    Preferred
  • Application/technical work experience:
    Preferred
  • One year leadership experience:
    Preferred

• Certification in Current Procedural Terminology (CPT) coding:
  Preferred

• Supports the creation and implementation of policies for operations, programs, and all activities to achieve a compliant, standard charge master across the health system and/or market, as applicable. Ensures that processes and data meet standards established by the regulatory bodies and Adventist Health executive leadership. Leads team of revenue integrity specialists, CDM coordinators, charge capture associates, charge assurance nurse auditors, and reporting and data analysts across the system and/or market, as applicable.
  
  Drives continuous improvement in revenue integrity and charge master activities including the identification and implementation of applications and/or vendor partnerships which enhance operational performance. Supports annual review of the CDM. Manages ongoing maintenance to ensure a compliant and complete charge master for professional and facility charges.
• Leverages automation through electronic health record (EHR) and technology to streamline processes and maximize the effectiveness of the department. Ensures support to revenue cycle for change related denials and CDM adaptation for payer specific requirements. Supports all pricing strategies and pricing policies for Adventist Health, and ensures team follows established pricing guidelines. Manages tasks within the department to ensure charge codes and charge capture processes exist for all patient services, medications, and supplies.
  
  Requires strong communication and influencing skills with clinical leaders and IT staff to guide work performed in other areas of the organization. Compiles complex financial analysis to understand gross and net revenue implications of charging decisions and/or assess compliance issues.
• Reviews, monitors, and analyzes revenue performance and status on a regular basis to identify trends and strategize for continuous improvement and course correction. Supports strategic audits to identify opportunities to streamline charge capture processes and increase net revenue. Supports team on validating integrity of charges with ability to provide corrective action plans to remediate where necessary. Serves as the system and/or market’s leading authority regarding reimbursement issues.
  
  Communicates status and potential issues to revenue integrity leadership and supports related organizational preparation initiatives including process and system changes,…