The Director of Revenue Quality and Optimization reports to the Senior Director of Revenue Cycle Services which includes Analytics, Charge Integrity, Revenue Liaison Services, Technology, Training and Services. The Director of Revenue Quality is responsible for the planning, development and implementation of initiatives that improve revenue results and maximize revenue opportunities.
The Director of Revenue Quality and Optimization is responsible for two teams: Revenue Quality Liaisons, who play a high-profile role tasked with communicating revenue related trends to clinical and hospital departments as well as helping customers navigate Revenue Cycle. They are responsible for managing strong collaborations and relationships with targeted groups. They are data driven, monitor performance and analyze results to provide actionable recommendations. The Charge Integrity Unit responsible for charge capture and workflow optimization this includes charge master oversight and maintenance, charge capture automation through appropriate workflows, charge reconciliation monitoring tools for departments, and managing work queues to ensure the accuracy and timeliness of charge capture.
The University of Michigan Health System improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
- Provide leadership and oversight of assigned units to ensure efficient and high-quality performance
- Provide vision and strategy across multi-disciplinary teams regarding charging and revenue optimization
- Recommend and implement revenue improvement initiatives
- Hire, fire, train staff
- Budget oversight
- Establish strong partnership with Clinical, Revenue Cycle and IT leaders
- Research, develop and implement best practices in collaboration with customers and stake holders
- Align efforts, reduce redundancy, and ensure efficiencies between Revenue Quality Liaisons and Charge Integrity
- Represent Revenue Cycle with internal and external customers
- Develop and implement performance measures for team and customers
- Develop and maintain organizational communication for transparency of work to customers
- Ensure charge work queues are worked timely to ensure revenue is booked
- Develop and maintain pricing and charge capture policy and procedure
- Ensures the ongoing accuracy and integrity of the CDM and professional fee schedules by ensuring all charges are communicated and coordinated with the performing departments and physicians.
- Identifies services that are reimbursable but are not being charged for
- Reviews assigns and validates CPT, HCPCS and revenue codes and sets rates
- Assists in the resolution of problems causing payer denial or failed edits as the involve the charge master and professional fee schedule
- Manage charge capture vendor relationships
- Share actionable data to customers to aid in improvement efforts: charge lag, charge reconciliation, avoidable write-offs etc. Work with Revenue Analytics to ensure dashboards are easy to use for customers
- Ensure new Epic modules and other systems impacting charges are thoroughly reviewed and do not negatively impact revenue
- Ensures adequate charging rules are in the system for maximum efficiency and improved revenue
- 5-8 years in a Revenue Cycle leadership role
- Bachelor’s degree in health care or business
- Strong leadership and interpersonal skills required
- Advanced knowledge or certification in Epic clinical and revenue applications
- Advanced knowledge of clinical operations and revenue cycle operations with ability to translate information
- Advanced knowledge in payer reimbursement, charge capture and compliance guidelines
- Excellent communication skills, demonstrated ability to communicate clear, concise and accurate information both verbally and in writing
- Proven ability to solve problems creatively
- Demonstrated ability to lead projects according to outlined scope and timeline
- Strong customer service skills
- Ability to establish and nurture beneficial business relationships
- Self-motivated with a willingness to take initiative and solve complex problems
- Capability to negotiate with and influence others
- Strong analytical skills, proven ability to analyze trends and determine root cause
- Ability to thrive in a demanding, high-pressure environment
- Flexibility, innovation, and creativity are necessary characteristics
- Desire to continuously learn and apply new improvement methodologies, and to spread successful innovation through the institution
- Coding Certification in one or more (CPC, COC, CCA, CCS, RHIT)
- Master’s degree Healthcare or IT field
- Previous management of Revenue Integrity Unit
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Although the Posting End Date may indicate otherwise, this job opening may be filled and closed any time after a posting duration of seven calendar days.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.
U-M COVID-19 Vaccination Policy
COVID-19 vaccinations are now required for all University of Michigan students, faculty and staff across all three campuses, including Michigan Medicine. This includes those working or learning remotely. More information on this policy is available on the Campus Blueprint website or the U-M Dearborn and U-M Flint websites.