What are the responsibilities and job description for the Director, Clinical Revenue Cycle position at TEKsystems?
Description
Provides operational oversight and strategic planning and execution for all areas of the Clinical Revenue Cycle. The Director of Clinical Revenue Cycle is responsible for planning, organizing, coordinating, managing, implementing, evaluating, and developing all areas of the Clinical Revenue Cycle, including but not limited to, Utilization Review, Clinical Appeals, CDM Management, and Revenue Integrity. This position serves a critical role in acting as a liaison between clinical and non-clinical departments, ensuring positive financial outcomes that match the delivery of care received by patients. Must guide and direct the utilization team to provide optimal financial outcomes for the facility. This position develops and integrates strategies to ensure financial management, leadership, quality and operational management objectives. The Director functions as the internal resource on issues related to appropriate utilization of resources, coordination of care across the continuum and utilization review and management. Essential Duties and Responsibilities These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned. Supervise the performance of Utilization Review, Revenue Integrity, and CDM team members Evaluate staff performance and productivity to ensure optimal use of resources Direct the overall activities of the Utilization Review team and implement efficiency measures Develop and achieve departmental goals and objectives to ensure organization metric goals are achieved Perform random audits to ensure appropriateness and timeliness of Utilization Review activities Monitor documentation in the software platforms for appropriate use Work closely with peers and leadership team to ensure the timely resolution of issues Maintain data and metrics to submit to the Revenue Cycle Committee Report and develop timely reports to submit to the Utilization Management Committee as directed Review Utilization Review plans annually, revising as necessary, and submit for approval by the Utilization Committee and Medical Executive Committee Assist with development and maintenance of department budget and ensure that the department operates within the allocated funds Manages all appeals related to denials for all payers Implement strategies to reduce denials while optimizing revenue Ensure all hospitalized patients have the correct admission status so that an appropriate claim can be submitted to the payer Oversee and coordinate the Utilization Review program's development to include the hospital resources as necessary to support its success Facilitate and foster staff and physician participation in the development and/or process revenue cycle operations Engage in improvement activities and events that maximize financial support for the hospital Communicate Utilization Review results through appropriate committees Develop and implement a continuous process improvement plan Supervisory Responsibilities Reports to: Sr Director, Revenue Cycle Supervises: Utilization Review RN, Revenue Integrity, CDM Management
Skills
RN, Utilization Review, Bachelors, Coder, Charge Master, Revenue Integrity
Top Skills Details
RN,Utilization Review,Bachelors
Additional Skills & Qualifications
Minimum Required Education: Bachelor’s degree in healthcare administration, nursing, health informatics, business, or a related field. Five years of management experience will be considered in lieu of degree. Preferred Education: Master’s degree Experience: Three (3) years of experience in direct patient care RN experience in an acute care environment. Five (5) years of experience in Utilization Review or Case Management department performing utilization review activities, with at least two (2) years of utilization review for an acute care environment. Certified Professional Coder CPC preferred. Certified Case Manager (CCM) or Accredited Case Manager (ACM) within 2 years of eligibility. Experience with Epic EMR is required. Certificates, Licenses, Registrations If the degree is in Nursing, an active RN license is required
Experience Level
Expert Level
Job Type & Location
This is a Permanent position based out of Chesapeake, VA.
Pay And Benefits
The pay range for this position is $100000.00 - $130000.00/yr.
Benefits & Perks Chesapeake Regional Healthcare offers a comprehensive and competitive benefits package designed to support employees’ health, financial wellness, and work‑life balance, including: Medical, Dental & Vision Coverage Multiple medical plan options through Aetna, including HSA‑eligible plans Tiered provider network with lower out‑of‑pocket costs for CRH providers Prescription drug coverage and access to CRH pharmacy services Comprehensive dental and vision plans Health & Wellness Programs On‑site Quick Care Clinic and virtual care options Employee‑only GLP‑1 Weight Loss Management Program (for eligible participants) Smoking cessation, chronic disease management, and fitness programs On‑site fitness center and wellness incentives through the HEALTHYme program Financial & Retirement Benefits Retirement savings plans with employer match and vesting Employer‑funded Health Savings Account (HSA) contributions (for eligible plans) Financial wellness coaching and planning resources through UBS Flexible Spending Accounts (Healthcare and Dependent Care) Paid Time Off & Leave Generous Paid Annual Leave (PAL) with rollover options Observed paid holidays Short‑ and long‑term disability coverage (employer‑paid for eligible roles) Life & Income Protection Employer‑paid life insurance and AD&D coverage Optional voluntary life insurance for employees and dependents Additional Voluntary Benefits Employee Assistance Program (EAP) with confidential counseling and legal/financial support Critical illness, accident, and hospital indemnity plans Identity theft protection, legal resources, and pet insurance
Workplace Type
This is a hybrid position in Chesapeake,VA.
Application Deadline
This position is anticipated to close on May 1, 2026.
h4>About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems And TEKsystems Global Services
We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Provides operational oversight and strategic planning and execution for all areas of the Clinical Revenue Cycle. The Director of Clinical Revenue Cycle is responsible for planning, organizing, coordinating, managing, implementing, evaluating, and developing all areas of the Clinical Revenue Cycle, including but not limited to, Utilization Review, Clinical Appeals, CDM Management, and Revenue Integrity. This position serves a critical role in acting as a liaison between clinical and non-clinical departments, ensuring positive financial outcomes that match the delivery of care received by patients. Must guide and direct the utilization team to provide optimal financial outcomes for the facility. This position develops and integrates strategies to ensure financial management, leadership, quality and operational management objectives. The Director functions as the internal resource on issues related to appropriate utilization of resources, coordination of care across the continuum and utilization review and management. Essential Duties and Responsibilities These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned. Supervise the performance of Utilization Review, Revenue Integrity, and CDM team members Evaluate staff performance and productivity to ensure optimal use of resources Direct the overall activities of the Utilization Review team and implement efficiency measures Develop and achieve departmental goals and objectives to ensure organization metric goals are achieved Perform random audits to ensure appropriateness and timeliness of Utilization Review activities Monitor documentation in the software platforms for appropriate use Work closely with peers and leadership team to ensure the timely resolution of issues Maintain data and metrics to submit to the Revenue Cycle Committee Report and develop timely reports to submit to the Utilization Management Committee as directed Review Utilization Review plans annually, revising as necessary, and submit for approval by the Utilization Committee and Medical Executive Committee Assist with development and maintenance of department budget and ensure that the department operates within the allocated funds Manages all appeals related to denials for all payers Implement strategies to reduce denials while optimizing revenue Ensure all hospitalized patients have the correct admission status so that an appropriate claim can be submitted to the payer Oversee and coordinate the Utilization Review program's development to include the hospital resources as necessary to support its success Facilitate and foster staff and physician participation in the development and/or process revenue cycle operations Engage in improvement activities and events that maximize financial support for the hospital Communicate Utilization Review results through appropriate committees Develop and implement a continuous process improvement plan Supervisory Responsibilities Reports to: Sr Director, Revenue Cycle Supervises: Utilization Review RN, Revenue Integrity, CDM Management
Skills
RN, Utilization Review, Bachelors, Coder, Charge Master, Revenue Integrity
Top Skills Details
RN,Utilization Review,Bachelors
Additional Skills & Qualifications
Minimum Required Education: Bachelor’s degree in healthcare administration, nursing, health informatics, business, or a related field. Five years of management experience will be considered in lieu of degree. Preferred Education: Master’s degree Experience: Three (3) years of experience in direct patient care RN experience in an acute care environment. Five (5) years of experience in Utilization Review or Case Management department performing utilization review activities, with at least two (2) years of utilization review for an acute care environment. Certified Professional Coder CPC preferred. Certified Case Manager (CCM) or Accredited Case Manager (ACM) within 2 years of eligibility. Experience with Epic EMR is required. Certificates, Licenses, Registrations If the degree is in Nursing, an active RN license is required
Experience Level
Expert Level
Job Type & Location
This is a Permanent position based out of Chesapeake, VA.
Pay And Benefits
The pay range for this position is $100000.00 - $130000.00/yr.
Benefits & Perks Chesapeake Regional Healthcare offers a comprehensive and competitive benefits package designed to support employees’ health, financial wellness, and work‑life balance, including: Medical, Dental & Vision Coverage Multiple medical plan options through Aetna, including HSA‑eligible plans Tiered provider network with lower out‑of‑pocket costs for CRH providers Prescription drug coverage and access to CRH pharmacy services Comprehensive dental and vision plans Health & Wellness Programs On‑site Quick Care Clinic and virtual care options Employee‑only GLP‑1 Weight Loss Management Program (for eligible participants) Smoking cessation, chronic disease management, and fitness programs On‑site fitness center and wellness incentives through the HEALTHYme program Financial & Retirement Benefits Retirement savings plans with employer match and vesting Employer‑funded Health Savings Account (HSA) contributions (for eligible plans) Financial wellness coaching and planning resources through UBS Flexible Spending Accounts (Healthcare and Dependent Care) Paid Time Off & Leave Generous Paid Annual Leave (PAL) with rollover options Observed paid holidays Short‑ and long‑term disability coverage (employer‑paid for eligible roles) Life & Income Protection Employer‑paid life insurance and AD&D coverage Optional voluntary life insurance for employees and dependents Additional Voluntary Benefits Employee Assistance Program (EAP) with confidential counseling and legal/financial support Critical illness, accident, and hospital indemnity plans Identity theft protection, legal resources, and pet insurance
Workplace Type
This is a hybrid position in Chesapeake,VA.
Application Deadline
This position is anticipated to close on May 1, 2026.
h4>About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems And TEKsystems Global Services
We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Salary : $100,000 - $130,000