What are the responsibilities and job description for the Manager, Revenue Integrity (Full-Time, 40, Day) position at Queens Health Systems?
Apply for Job Job ID 157993 Location Queen's Health Systems Full/Part Time Full-Time Regular/Temporary Regular Starting Pay $101,696.00 to $129,662.00 annual salary The starting pay displayed above may be higher commensurate with experience, or subject to the provisions of the applicable collective bargaining agreement. Add to My Favorite Jobs Email this Job
Responsibilities
I. JOB SUMMARY:
• Oversees, manages and evaluates clinical and financial processes to improve revenue results, ensures integrity, and safeguards The Queen’s Health Systems (QHS) medical facilities against exposure and penalties.
• Provides leadership and oversight in the accomplishment of organizational goals and objectives related to revenue integrity, managed care contracts, government reimbursement activities, and QHS Charge Description Masters (CDM).
• Prepares and presents financial reports for executive management review.
• Manages and directs the development and implementation of new and existing managed care contracts.
• Provides oversight over existing managed care contracts to ensure compliance and optimal financial and operational performance.
• Develops, manages and sustains relationships with third party payers and other external contacts.
II. TYPICAL PHYSICAL DEMANDS:
A. ESSENTIAL FUNCTIONS:
II. TYPICAL PHYSICAL DEMANDS:
A. ESSENTIAL FUNCTIONS:
• Seeing. Hearing. Speaking. Finger dexterity.
B. MANUAL MATERIAL HANDLING:
B. MANUAL MATERIAL HANDLING:
• Infrequent: N/A
• Occasional: Lift waist to shoulder between 0-5 lbs. Carry between 0-5 lbs.
• Frequent: N/A
• Constant: N/A
C. NON-MANUAL MATERIAL HANDLING:
C. NON-MANUAL MATERIAL HANDLING:
• Infrequent: N/A
• Occasional: Stand. Walk. Stoop/Bend. Climb: Stairs/Ladder. Reach: shoulder level.
• Frequent: N/A
• Constant: Sit.
III. TYPICAL WORKING CONDITIONS:
III. TYPICAL WORKING CONDITIONS:
• Not substantially subjected to adverse environmental conditions.
IV. MINIMUM QUALIFICATIONS:
A. EDUCATION:
IV. MINIMUM QUALIFICATIONS:
A. EDUCATION:
• Bachelor's degree in Business Administration, Finance or Health Care Administration; or four (4) years experience in revenue cycle or finance may be substituted for the educational requirement.
• Master's degree preferred.
B. CERTIFICATION AND LICENSURE:
B. CERTIFICATION AND LICENSURE:
• No certification and/or licensure requirement.
C. EXPERIENCE:
C. EXPERIENCE:
• Five (5) years experience in revenue cycle, including revenue integrity, charge capture, compliance, pricing and reimbursement, preferably in a comparable organization.
• Two (2) years supervisory/leadership experience.
• Experience to demonstrate:
o Knowledge of contracts, financial analysis methods, accounting principles and health care delivery systems.
o Knowledge of requirements specific to government-funded health care program and third party payer reimbursement.
o Knowledge of contracts, financial analysis methods, accounting principles and health care delivery systems.
o Knowledge of requirements specific to government-funded health care program and third party payer reimbursement.
• Prior experience in healthcare insurance provider contract negotiations experience preferred.
Equal Employment Opportunity
Equal Opportunity Employer / Disability / Vet
Your Health. Our Legacy
Our Mission: To fulfill the intent of Queen Emma and King Kamehameha IV to provide in perpetuity quality health care services to improve the well-being of Native Hawaiians and all of the people of Hawai‘i.
Our Values:
C ompassion guides our actions
A loha inspires us in all that we do
R espect and understanding are essential for the dignity of all
E xcellence is our quest
Salary : $101,696 - $129,662