Apply on Employer Site

Stanford Health Care · 1 week ago

Revenue Integrity Program Manager (Remote)

United States

Full-time

Remote

Senior Level

$66.52/hr - $88.14/hr

5+ years exp

Stanford Health Care is a leading healthcare provider committed to innovation and excellence. They are seeking a Revenue Integrity Program Manager responsible for optimizing hospital and professional revenue while ensuring compliance in charging and billing practices. The role involves data analytics, process improvement, and collaboration with clinical departments to enhance revenue cycle operations.

Health CareHealth DiagnosticsHospitalMedicalPrimary and Urgent Care

Comp. & Benefits

H1B Sponsor Likely

Responsibilities

Charging Optimization: Conducts prospective and retrospective reviews/audits of charge capture practices in the clinical departments. Reports findings, provides education to both Providers and charge capture support staff. Coordinates charge capture improvement tools in collaboration with Revenue Cycle TDS IT teams. Reports potential compliance issues for further analysis and follow-up to the Compliance Department

CDM Optimization: Works to ensure a compliant and consistent system CDM. Works with existing tools to evaluate CDM requests with a focus on regulatory coding, compliance, and adherence to SHC internal guidelines regarding CDM maintenance, standard naming conventions and pricing integrity

Department Education: In collaboration with the Compliance Department, provides education to clinical department staff regarding CPT codes, HCPCS codes, revenue codes and modifiers and their compliance use

Project Management: Leads projects to improve revenue capture, increase efficiencies in the charge capture process, and reduce provider burden with the charging process

Financial Analysis: Performs basic financial analyses to report the impact of charge capture practice changes and corrections to current practices. Communicates findings fully with clinical departments and executive team

Issue Resolution: Through the combination of EPIC WQs, external edit platforms, and ongoing evaluation, identifies charging issues and works to identify solutions

Performance Review: Provides ongoing reporting of revenue performance to a variety of audiences including Chairs, Faculty, DFA’s, Division and Clinic Chiefs, Executive Director, Mid-Revenue Cycle, the Director of Revenue Integrity and others as appropriate. Responsible to present confidently to a wide range of individuals across the organization

Qualification

Revenue Cycle OperationsData AnalysisCoding ConventionsEpic CareProject ManagementCommunication SkillsInterpersonal SkillsProblem SolvingOrganizational SkillsLeadership SkillsAttention to Detail

Required

Bachelor's degree in a work-related discipline/field from an accredited college or university (or equivalent combination of education/experience)

Five (5) years of progressively responsible directly related work experience

Proficient in hospital and professional revenue cycle operations

Expert in analyzing revenue data to identify trends and opportunities with the capacity to communicate findings effectively to varied audiences

Strong Interpersonal skills facilitating seamless communication with clinical staff, and faculty

Solid understanding of coding conventions and current third-party payer rules and regulations

Current knowledge of third party payer rules and regulations

Knowledge of computer systems, specifically, Epic Care and related interfaces

Knowledge of management and supervision and the ability to organize staff's work

Strong written and verbal communication skills to articulate analyses and finding to Chairs, DFAs and Clinical Operations leadership

Proven Ability to provide leadership skills in problem identification and issue resolution

Ability to influence decision-making through persuasive data-supported arguments

Ability to apply critical thinking skills to complex issues and situations

Competence in mediating and solving intricate work problems

Ability to effectively facilitate work groups towards to successful outcomes

Ability to facilitate stakeholder meetings, including agenda development, discussion, documentation, action item follow-up and presentation development

Strong organizational skills and attention to detail, with the ability to manage multiple priorities effectively

Preferred

Non Clinical COC - Certified Outpatient Coder

CPC-H

CCS - Certified Coding Specialist

CPC and/or CCSP - Certified Professional Coder

RHIT - Registered Health Information Technician

RHIA - Registered Health Information Administrator

Company

Stanford Health Care

Glassdoor4.0

Stanford Health Care is a healthcare center that treats cancer, heart disease, brain disorders, and primary care issues.

Founded in 1885

Palo Alto, California, USA

10001+ employees

https://stanfordhealthcare.org

H1B Sponsorship

Stanford Health Care has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (102)

2024 (74)

2023 (82)

2022 (55)

2021 (54)

2020 (67)