Senior Director – Revenue Integrity

Role Overview

• Develops organizational strategies for enterprise-wide hospitals and professional revenue integrity, including long-range plans and annual goals.
• Leads policy development for charging, charge capture, validation, charge reconciliation, CDM Governance and documentation integrity.
• Oversees integration of revenue integrity operations across clinical departments, SOM leadership, Patient Financial Services, Office of Compliance & Privacy, HIM, and Coding.
• Represents Revenue Integrity as a senior leader on enterprise committees, Steering Committees, Quality & Compliance groups, and major IT optimization programs.
• Serves as a thought leader and change agent, driving innovation, automation, and best practice across the revenue integrity functions.
• Ensures timely, accurate, and compliant completion of all charge capture, CDM maintenance, reconciliations, and revenue validation activities.
• Designs and oversees comprehensive quality assurance programs for charging accuracy, documentation integrity, coding quality integration, and loss prevention.
• Utilizes Lean, Six Sigma, and process improvement methodologies to optimize workflows and eliminate preventable revenue leakage.
• Ensures the appropriate EPIC system configuration, workflow alignment, and adoption of technology enhancement opportunities.
• Serves as the primary liaison for SHC revenue integrity matters to School of Medicine DFAs, Clinical Department Chairs, clinical leadership, and administrative partners.
• Directs preparation of enterprise dashboards, KPIs, business reviews, and executive level reporting.
• Educates hospital and professional revenue generating departments on charge capture requirements, compliance, and CDM practices.
• Oversees governance of the hospital CDM and SOM professional fee schedule to ensure regulatory compliance and revenue accuracy.
• Approves additions, deletions, and modifications stemming from new services, regulatory updates, payor requirements, and clinical changes.
• Leads enterprise initiatives to mitigate late charges, preventable denials, claim edit failures, and avoidable under billing. Identifies meaningful revenue opportunities using analytics, benchmarking, and auditing.
• Partners with IT, EPIC leadership, Revenue Cycle Optimization and digital innovation teams to enhance revenue impacting workflows.

Requirements

• Bachelor’s degree from an accredited college or university with a major in business administration, health care administration, or a related field
• 10+ years of progressive leadership experience in hospital and/or professional revenue integrity, charge capture, CDM governance, HIM, Coding, or Revenue Cycle functions.
• 5+ years EPIC experience (HB/PB billing, clinical documentation, charge capture technologies).
• Experience working in an academic medical center.
• Member in Healthcare Financial Management Association or the American Academy of Professional Coders or American Health Information Management Association Preferred

Benefits

• Health insurance
• Retirement plans
• Paid time off
• Professional development
• Flexible work arrangements