Senior Director – Revenue Integrity
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Job Description
Strategic leader managing enterprise-wide revenue integrity operations at Stanford Health Care. Developing strategies for enhanced revenue performance and regulatory compliance while leading cross-functional teams.
Responsibilities:
- 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
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