Providence St. Joseph Health

Job Information

St. Joseph Health / Covenant Health Director, Revenue Intergrity in Santa Rosa, California

We are looking for a Director, Revenue Integrity with the Patient Finance Area at Santa Rosa Memorial Hospital.

Location: Santa Rosa, CA

Work Schedule: Full time - 80 Biweekly hours

Shift: 10 Hour - Day shift

Job Summary:

Contributes to the fulfillment of the organization's mission and vision by planning, designing, implementing, maintaining and monitoring the effectiveness of the Revenue Integrity Program for Northern California ministries.

Coordinates and facilitates the development of the Revenue Integrity Program by effectively, but compliantly pursuing net revenue for services rendered in accordance with federal/state billing regulations and third party contract provisions.

Oversees the management of the assigned Revenue Integrity staff in the performance of their duties related to charge accuracy audits, revenue cycle support services, education of departments regarding proper charging and government billing edits (NCCI, MUE’s, coding pairs, LCD and NCD), etc. Identifies root causes, reports findings to leadership, and works with other department leaders to address associated issues.

Serves as a role model for ethical management behavior and promotes an awareness and understanding of positive ethical and moral principles consistent with the mission, vision and values of the organization and those required by law. Sets the standard through leadership and encourage and stimulate a culture of ethical sensitivity and compliant behavior.

Skills:

  • Knowledge of all aspects of healthcare revenue cycle functions, including registration, coding and documentation standards, billing and collection processes, as well as government and payer regulations.

  • Knowledge of CMS regulations, medical terminology and the various data elements associated with the UB‐04 and CMS‐1500 claim form.

  • Knowledge of medical records, hospital bills, and service item master.

  • Knowledge of principles and practices of organization, administration, fiscal and personnel management.

  • Knowledge of local, state and federal regulatory requirement related to the functional area.

  • Ability to conduct and interpret qualitative and quantitative analysis, financial analysis, healthcare economics and business processes, information systems, organizational development, health care delivery systems, project management or new business development.

  • Ability to manage, organize, prioritize, multi‐task and adapt to changing priorities.

  • Ability to provide leadership and influence others.

  • Ability to foster effective working relationships and build consensus.

  • Ability to mediate and resolve complex problems and issues.

  • Ability to develop long‐range business plans and strategy

Minimum Position Qualifications:

Education : Bachelor's degree in a related field/discipline from an accredited college or university or equivalent education and experience.

Experience : 7 years progressively responsible and directly related work experience. Any combination of education and experience that would likely provide the required knowledge, skills and abilities is qualifying.

Preferred Position Qualifications:

License/Certification: Member in Healthcare Financial Management Association or the American Academy of Professional Coders or American Health Information Management Association.

The people of St. Joseph Health have worked for 53 years to improve health and quality of life in California's North Bay region, starting in Sonoma County, where the Sisters of St. Joseph of Orange opened the doors of Santa Rosa Memorial Hospital in 1950. Today, we continue the mission begun by the Sisters and continued through the St. Joseph Health Ministry of extending the healing ministry of Jesus to those we serve through an integrated spectrum of primary, urgent, acute, outpatient, palliative care and regional referral services. Sonoma County entities aligned with St. Joseph Health include the 278-bed Santa Rosa Memorial Hospital, the region's only Level II trauma center, as well as the 80-bed Petaluma Valley Hospital. Our services also encompass three Urgent Care centers, Hospice of Petaluma, Memorial Hospice and North County Hospice, the Annadel Medical Group, as well as the St. Joseph Home Care Network. We act as a regional referral hub for outlying hospitals, while also providing outpatient behavioral health care, education to promote health and prevent chronic disease, rehabilitation, oral health care, community benefit programs, and more, all fostering health and quality of life throughout the area.St. Joseph Health provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, St. Joseph Health complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training..Positions specified as “on call/per diem” refers to employment consisting of shifts scheduled on as “as needed basis” to fill in for staff vacancies.

Company: Sonoma County Entities

Category: Non-Clinical Director/ Executive

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