The Queen's Health Systems logo

Manager, Revenue Integrity (Full-Time, 40, Day)

The Queen's Health Systems

Honolulu, HIFull-timeSeen 2w agoSeen in employer's feed today

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At a glance

Compensation
No compensation found
Location
Honolulu, HI
Schedule
Full-time
Work Authorization
Not specified

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Requirements

Credentials this posting asks for.

Bachelor's degree

Job overview

The Manager, Revenue Integrity oversees and evaluates clinical and financial processes to improve revenue results, ensures integrity, and safeguards The Queen’s Health Systems facilities. The role provides leadership for revenue integrity, managed care contracts, government reimbursement, prepares executive financial reports, and develops payer relationships.

Skills & qualifications

RequiredNice to have

Skills

Revenue CycleRevenue IntegrityCharge CaptureCompliancePricingReimbursementContracts KnowledgeFinancial Analysis MethodsAccounting PrinciplesHealth Care Delivery SystemsGovernment‑Funded Health Care ProgramsThird‑Party Payer ReimbursementSupervisory Leadership

Qualifications

Bachelor's Degree in Business Administration, Finance or Health Care AdministrationMaster's Degree PreferredFive Years Experience in Revenue CycleTwo Years Supervisory/Leadership ExperiencePrior Experience in Healthcare Insurance Provider Contract Negotiations Preferred

Full job description

RESPONSIBILITIES

I. JOB SUMMARY:

  • Oversees, manages and evaluates clinical and financial processes to improve revenue results, ensures integrity, and safeguards The Queen’s Health Systems (QHS) medical facilities against exposure and penalties.

  • Provides leadership and oversight in the accomplishment of organizational goals and objectives related to revenue integrity, managed care contracts, government reimbursement activities, and QHS Charge Description Masters (CDM).

  • Prepares and presents financial reports for executive management review.

  • Manages and directs the development and implementation of new and existing managed care contracts.

  • Provides oversight over existing managed care contracts to ensure compliance and optimal financial and operational performance.

  • Develops, manages and sustains relationships with third party payers and other external contacts.

II. TYPICAL PHYSICAL DEMANDS:

A. ESSENTIAL FUNCTIONS:

  • Seeing. Hearing. Speaking. Finger dexterity.

B. MANUAL MATERIAL HANDLING:

  • Infrequent: N/A

  • Occasional: Lift waist to shoulder between 0-5 lbs. Carry between 0-5 lbs.

  • Frequent: N/A

  • Constant: N/A

C. NON-MANUAL MATERIAL HANDLING:

  • Infrequent: N/A

  • Occasional: Stand. Walk. Stoop/Bend. Climb: Stairs/Ladder. Reach: shoulder level.

  • Frequent: N/A

  • Constant: Sit.

III. TYPICAL WORKING CONDITIONS:

  • Not substantially subjected to adverse environmental conditions.

IV. MINIMUM QUALIFICATIONS:

A. EDUCATION:

  • Bachelor's degree in Business Administration, Finance or Health Care Administration; or four (4) years experience in revenue cycle or finance may be substituted for the educational requirement.

  • Master's degree preferred.

B. CERTIFICATION AND LICENSURE:

  • No certification and/or licensure requirement.

C. EXPERIENCE:

  • Five (5) years experience in revenue cycle, including revenue integrity, charge capture, compliance, pricing and reimbursement, preferably in a comparable organization.

  • Two (2) years supervisory/leadership experience.

  • Experience to demonstrate:

o Knowledge of contracts, financial analysis methods, accounting principles and health care delivery systems.

o Knowledge of requirements specific to government-funded health care program and third party payer reimbursement.

  • Prior experience in healthcare insurance provider contract negotiations experience preferred.

Equal Opportunity Employer/Disability/Vet

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