UCSF Health · 10 hours ago
Director of Revenue Management
Emeryville, CA
Full-time
Onsite
Director/Executive
$144K/yr - $350K/yr
10+ years expUCSF Health is a leading healthcare provider committed to innovative patient care and advanced technology. The Director of Revenue Management is responsible for directing the revenue integrity strategy and initiatives, overseeing the Revenue Integrity team, and ensuring compliant and accurate revenue practices across hospital and professional billing environments.
BiotechnologyEducationHealth CareHospitalMedical
Responsibilities
The Director oversees the Revenue Integrity (RI) team and has enterprise responsibility for Charge Description Master (CDM) governance, pricing, accurate and compliant charge capture, documentation alignment, revenue monitoring, and proactive identification and mitigation of denial risk
Responsibilities include the structure and maintenance of the CDM and professional fee schedules; development, implementation, and oversight of policies and processes related to compliant charging and coding practices; pricing strategy, analysis, and modeling; and proactive monitoring of gross revenue performance and revenue risk
The Director collaborates extensively with clinical departments, Health Information Management, Patient Financial Services, Compliance, Internal Audit, Health Plan Strategy, Finance, and Information Technology teams to ensure revenue integrity requirements are embedded into operational and technical workflows
This includes partnership with IT and Epic application teams to optimize system design, automation, testing, and validation of charge capture and billing workflows to ensure accuracy, efficiency, and safeguarding of revenue
The Director interacts with executives, other directors, internal and external auditors, compliance leadership, operational leaders, physicians and their staff, and UC system counterparts
External contacts include state and federal agencies, regulatory bodies, vendors, and external auditors
The Director contributes to short- and long-range planning for revenue cycle strategies, processes, tools, and systems; establishes departmental goals, budgets, and staffing plans; and develops policies that affect revenue integrity and revenue cycle functions across UCSF Health
Qualification
Required
Bachelor's degree in relevant field such as, Business, Management, or Health Administration; or equivalent experience
Ten (10) years of experience in hospital and professional revenue cycle leadership, charge description master maintenance, clinical charge capture, coding, government/third-party reimbursement, or similar healthcare experience
Possession of 1 or more of the following certifications: CPAM – Certified Professional in Ambulatory Management (MGMA), CHRI – Certified Healthcare Revenue Integrity (AAPC), CHC – Certified in Healthcare Compliance (HCCA), CPC – Certified Professional Coder (AAPC), CCS – Certified Coding Specialist (AHIMA)
Experience in managing and/or developing charge description master, fee schedules, and charge capture processes, policies, and/or procedures
Practical experience using hospital information systems, Epic preferred, and computer proficiency with PC applications (e.g. Microsoft Office)
Practical experience and knowledge of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and Revenue codes
In-depth knowledge of overall revenue cycle processes, specifically revenue integrity, including industry trends
Demonstrated leadership experience in a healthcare setting, preferable within a medical facility or health system
Knowledge of applicable laws, regulations, requirements, standards and practices pertaining to patient confidentiality and information management
Demonstrated analytical and decision-making skills
Demonstrated professional interpersonal and communication skills
Excellent organizational, time management, and project management skills; ability to manage multiple, competing priorities
Detail-oriented, good organizational skills, and ability to be self-directed
Ability to present to and interact with all levels of hospital management and physician leaders
Ability to plan, document, direct, monitor and coordinate workflows
Preferred
Master's degree in related health care or business area and/or equivalent experience/training
Company
UCSF Health
UCSF Health offers healthcare services in the areas of cancer, heart disorders, neurological disorders, organ transplants, and more.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Elizabeth Engel
Vice President and Chief of Staff to the CEO
Suresh Gunasekaran
President & Chief Executive Officer
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