Stanford Health Care is hiring a Revenue Integrity Program Manager (Remote)

Stanford Health Care is looking for a Revenue Integrity Program Manager to optimize hospital and professional revenue, identify potential revenue leakage, and ensure compliant charging and billing practices. This role serves as the primary liaison for Revenue Cycle, interfacing directly with clinical department leaders, Chairs, and Directors of Finance & Administration.

What You'll Do

• Conduct prospective and retrospective reviews and audits of charge capture practices across clinical departments.
• Report findings and provide targeted education to Providers and charge capture support staff.
• Coordinate the development of charge capture improvement tools with Revenue Cycle TDS IT teams.
• Report potential compliance issues to the Compliance Department.
• Ensure a compliant and consistent system Charge Description Master (CDM).
• Evaluate CDM requests with a focus on regulatory coding, compliance, and internal guidelines.
• Provide education to clinical department staff regarding CPT codes, HCPCS codes, revenue codes, and modifiers in collaboration with Compliance.
• Lead projects to improve revenue capture, increase charge capture process efficiencies, and reduce provider burden.
• Perform basic financial analyses to report the impact of charge capture practice changes.
• Identify charging issues through EPIC WQs and external edit platforms and work to find solutions.
• Provide ongoing reporting of revenue performance to Chairs, Faculty, DFAs, Division and Clinic Chiefs, and other executives.

What We're Looking For

• A Bachelor's degree in a work-related discipline/field from an accredited college or university (or an equivalent combination of education and experience).
• Five (5) years of progressively responsible, directly related work experience.
• Proficiency in hospital and professional revenue cycle operations.
• Expertise in analyzing revenue data to identify trends and opportunities.
• Strong interpersonal skills for effective communication with clinical staff and faculty.
• Solid understanding of coding conventions and current third-party payer rules and regulations.
• Knowledge of computer systems, specifically Epic Care and related interfaces.
• Knowledge of management and supervision and the ability to organize staff's work.
• Strong written and verbal communication skills to articulate analyses to leadership.
• Proven ability to provide leadership in problem identification and issue resolution.
• Ability to influence decision-making through persuasive, data-supported arguments.
• Ability to apply critical thinking skills to complex issues and situations.
• Ability to mediate and solve complex work problems and issues.
• Ability to effectively facilitate work groups towards successful outcomes.
• Strong organizational skills and attention to detail, with the ability to manage multiple priorities effectively.

Nice to Have

• Certified Outpatient Coder (COC)
• Certified Professional Coder - Hospital (CPC-H)
• Certified Coding Specialist (CCS)
• Certified Professional Coder (CPC) and/or Certified Coding Specialist - Physician (CCSP)
• Registered Health Information Technician (RHIT)
• Registered Health Information Administrator (RHIA)

Technical Stack

• Epic Care

Team & Environment

You will serve as the primary liaison for Revenue Cycle, interfacing with clinical department leaders, Clinical Department Chairs, and School of Medicine Directors of Finance & Administration. You will report to the Director of Revenue Integrity.

Benefits & Compensation

• Compensation generally starts at $66.52 - $88.14 per hour.

Work Mode

This is a remote position with Stanford Health Care.

Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above.