Revenue Integrity Manager

About the job

Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, andyour community? At Children’s Hospital of Michigan, we’re seeking an innovative and experienced healthcareleader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.

Benefits Statement

At Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include: • Medical, dental, vision, and life insurance • 401(k) retirement savings plan with employer match • Generous paid time off (PTO) • Career development and continuing education opportunities • Health savings accounts, healthcare & dependent flexible spending accounts • Employee Assistance program, Employee discount program • Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.

Note: Eligibility for benefits may vary by location and is determined by employment status

Job Summary

Reports to the Director Revenue Analysis and manages the revenue analysis function for the assigned hospital and ambulatory sites. Responsible for preparation and completion of eReserve. Responsible for the analysis of eReserve and items/trends that significantly impact net revenue. Responsible for the review and approval of manual adjustments and refunds. Monitors/analyzes AR/Disputes and assists with Bad Debt Initiatives.

Monitors and communicates non-reimbursable charges (e.g., ABN not signed, denials, disputes, bad debt). Reviews proposed managed care contracts and identify any issues or concerns with implementation of the terms prior to the contract being finalized. Assists in analyzing data to verify contract terms have been loaded correctly into IMaCs and claims properly adjudicated during and after managed care negotiations.

Monitors/reviews billing, A/R and reconciliation for hospital specific contracts (e.g., non-IMaCs, local employer). Works with hospital departments to resolve revenue cycle issues (e.g., orders, charging, Patient Access, DNFB, DNSP, QS, disputes). Works with hospital leadership on revenue cycle issues. Works with hospital related entities (e.g., clinics, universities), if applicable.

Facilitates revenue cycle meetings (preparation, facilitation and follow-up). Supports/directs/monitors the following: department head meetings, chart audit meetings, compliance committees, charge master review/updates, pass through invoice retrieval, complex (e.g., 'High $" or "At-Risk") in-house patient meetings, hospital revenue cycle implementation initiatives, internal/external Audit Assistance, engaging legal for collection Issues.

Qualifications: Minimum Qualifications

• Bachelor's degree in Business, Health Administration or related area, or the equivalent combination of education and/or experience.

• Four or years of experience in A/R management and/or Managed Care contracting and analysis

Skills Required

• High level of analytical ability required to compile data in the revenue cycle; review, interpret and analyze complex financial reports and activities and present findings. Ability to understand relationships within the revenue cycle process, identify potential discrepancies and resolve complex business operational issues. Ability to evaluate processes and conduct cost and pricing studies. Analytical ability to evaluate processes and conduct cost pricing studies.

• Communication and/or interpersonal skills for contact with internal and external customers/stakeholders to obtain and interpret a variety of information based on knowledge of departmental practices, DMC policies and programs and specific technical and regulatory knowledge. Discretion must be exercised in deciding what and how to communicate. Conflict resolution skills must be exercised where policy issues are concerned both within the functional area and interdepartmentally. Diplomacy, tact and listening skills are required. Ability to read, interpret and write technical materials.

• Project management skills including the ability to define program, project, or process objectives, identify stakeholders and their interests, plan steps, coordinate and allocate human, technological and fiscal resources to accomplish goals and objectives in a resourceful yet timely manner.

• Thorough understanding of mathematical logic to compute figures related to complex financial studies, to see relationships between data and to draw valid conclusions.

• Strong technical knowledge of financial analysis billing and reimbursement experience.

• Thorough understanding of financial services computer systems, accounts receivable and collection report format, policies, and procedures.

• Proficient in the use of a personal computer and spreadsheet software.

Facility Description

Children’s Hospital of Michigan is an international leader in pediatric and adolescent medicine. Surgical services include general, thoracic, reconstructive and cardiovascular. Imaging technology designed specifically for children provides advanced diagnostic services including Positron Emission Tomography (PET) and MRI. The Children’s Hospital of Michigan Emergency Department is a verified Level 1 Pediatric Trauma Center and dedicated pediatric burn center. Experts in pediatric critical care, rehabilitation, and neonatal and perinatal medicine provide care for thousands of children every year at Children’s Hospital of Michigan, Children’s Hospital of Michigan - Troy and six ambulatory sites.

EEO Statement

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.

Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations

Job: Business Office

Primary Location: Detroit, Michigan

Facility: DMC Children's Hospital of Michigan

Job Type: Full Time

Shift Type: Day

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.

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