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

Responsibilities I. JOB

• 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.

• 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.

A.

• 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

• No certification and/or licensure requirement. C.

• 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 Employment Opportunity Equal Opportunity Employer / Disability / Vet Your Health. Our Legacy Our Mission: To fulfill the intent of Queen Emma and King Kamehameha IV to provide in perpetuity quality health care services to improve the well-being of Native Hawaiians and all of the people of Hawai‘i. Our Values: C ompassion guides our actions A loha inspires us in all that we do R espect and understanding are essential for the dignity of all E xcellence is our quest