This position is responsible for driving and supporting the Revenue Integrity function within Banner Health, including acute care hospitals, ambulatory surgery centers, Banner Medical Group (Physicians/Clinics) and other entities as appropriate. Promotes a collaborative, open, and inclusive work environment within a highly matrixed organization. Serves as a primary advisor to the organizations senior management on strategic aspects of Revenue Integrity. Monitors and oversees compliance with LCDs and NCDs (works closely with the Corporate Compliance), and other functions such that fall within the Revenue Integrity purview. This position is responsible for serving as a role model to staff across the system and representing Banner in a positive manner both within and outside the organization.
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 staffs 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 organizations Governing Board and/or applicable committees.
Bachelors 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 five years of progressively responsible managerial experience, including a minimum of two years management level experience within a healthcare system setting or large multi-operational, complex corporate environment.
Depending upon assigned area of responsibility, position may require applicable certifications and/or licensures, including but not limited to: RN; MD or DO; Drivers 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.
Three to five years experience in similar role in healthcare also preferred.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.