Fairview Health Services · 1 day ago
Director Revenue Cycle Integrity - CDM and Strategic Pricing
St Paul, MN
Full-time
Onsite
Director/Executive
7+ years expFairview Health Services is seeking a Director of Revenue Cycle who will provide leadership and accountability for operational excellence within Revenue Cycle functions. This role focuses on implementing strategies to maximize performance and ensure compliance while enhancing the patient financial experience.
AssociationHealth CareHospitalMedical
Responsibilities
Provides Strategic Direction for management of the Charge Description Master (CDM) and fee schedule pricing. This work facilitates accurate financial reporting for the organization, supports capture and categorization of patient care revenue by department or service line, provides data to manage resource utilization and inventory management, and supports Medicare and Medicaid cost reporting
Performs continuous assessment to help identify strengths, weaknesses, opportunities, and threats to revenue cycle functions. Identifies, evaluates, develops, and implements strategies and tactics to achieve organizational objectives
Establishes performance metrics and KPI’s that align with benchmark standards and result in daily maximum output supporting CDM and fee schedule pricing for the organization. Ensures leaders and team monitor and measure performance that results in leading practice outcomes for the organization
Oversees functions, priorities, and staff effectiveness to ensure maximum efficiency, achievement of outcomes and work that is executed in a compliant, accurate and timely manner
Responsible for managing effective and efficient charge master and fee schedule pricing operations including people, processes and technology that results in leading practice clean and compliant claim creation. Leads employees and influences stakeholders to follow appropriate standards, workflows and systematic improvement processes
Leads the department to ensure fully vetted, tested, and approved people, process and technology edits and changes that result in compliance with CPT/HCPC coding, National Uniform Billing Committee (NUBC) revenue codes, billing, payor, and regulatory requirements
Manages department leadership and teams. Ensures organizational structure, job descriptions and performance are optimized. Hires, orients, and trains leadership team. Assures development and implementation of key productivity and quality standards for department processes. Establishes and works with leadership team to monitor and manage productivity and quality as well as creating efficiency leveraging technology to achieve leading practice performance
Guides and implements framework with leadership team that ensures routine evaluation of staff performance, meaningful feedback, coaching, and corrective action when necessary to support growth, development, and high performance
Works with leadership and team to ensure appropriate staff education, training and certification while ensuring a culture of diversity, equity and inclusion. Identifies opportunities and works with leadership and staff to implement plans to improve staff engagement. Establishes, maintains, and ensures appropriate education vehicles for team, remaining current with CPT/HCPC coding regulations and payer billing requirements
Performs succession planning and individualized plans to provide development opportunities within the organization. Understands and follows human resource policies and procedures
Oversees the activities of outsourced/ partnership with external vendors including implementation and on-going performance. Represents Revenue Cycle and Fairview Health Services at industry forums to network and identify process improvement opportunities
Provides oversight to ensure compliance with established laws, regulations, practices, and procedures. Maintains self and team knowledge of, and complies with, all relevant laws, regulations, policies, procedures, and standards
Monitors Finances. Develops and monitors budgets for assigned areas. Ensures key performance indicators are monitored and being met. identifies, evaluates, and implements, as appropriate, cost reduction opportunities Meets budget expectations. Develops and manages financial forecasts for entity. Along with senior management team, accountable for closing gap between run rate and target. Plans, directs, and oversees annual budget development and ongoing management for all areas of responsibility
Develops Strong Working Relationships. Leads or participates in work with peers and other departments to create an excellent understanding of workflows and interdependencies, and to identify and implement strategies to improve revenue cycle performance
Fosters a culture of improvement, efficiency, and innovative thinking
Creates structures and processes within team and internal customers to continuously optimize and improve processes to mitigate delays, errors and defects that result in denials and write-offs and improve transparency of the patient’s financial journey
Creates and cultivates culture of analysis, trends, issues, risk and resolution tracking with team and customers to identify patterns and appropriate solutions in a timely manner
Performs other responsibilities as needed/assigned
Qualification
Required
Bachelor's degree. Four years of experience in an applicable field may substitute for a bachelor's degree
Total of 7 years of relevant department experience
5 years of progressive leadership experience
Experience engaging in implementation of new processes, enterprise-wide initiatives and/or Technologies
Epic Resolute Certification(s) in one or more of the following Epic applications: Resolute Hospital Billing Charging, Resolute Professional Billing Claims, Resolute Hospital Billing Claims, OR ability to obtain certification within one year of hire
Preferred
Bachelor's or Master's degree
7 years progressive leadership experience in revenue cycle functional area
Experience leading a department of multiple leaders
RHIA, RHIT, CHRI, CCS, CPC certification
Epic certification in Resolute Hospital Billing Charging
Benefits
Medical
Dental
Vision plans
Life insurance
Short-term and long-term disability insurance
PTO and Sick and Safe Time
Tuition reimbursement
Retirement
Early access to earned wages
Company
Fairview Health Services
Fairview Health Services is a nonprofit healthcare organization that provides various medical and wellness services.
10001+ employees
H1B Sponsorship
Fairview Health Services 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 (5)
2024 (5)
2023 (3)
2022 (9)
2021 (7)
2020 (5)
Funding
Current Stage
Late StageTotal Funding
unknown2022-11-15Acquired
Leadership Team
James Hereford
President and CEO
Joe Gaylord
Executive Vice President & Chief Financial Officer
Recent News
2025-12-17
Twin Cities Business
2025-12-09
2025-11-23
Company data provided by crunchbase