Manager of Revenue Cycle Appeals

You were meant for Hopkins! Come see why the Johns Hopkins Hospital is a world-renowned leader in patient care, serving the greater Baltimore community and patients from all across the globe. Our friendly and knowledgeable staff teams provide support throughout our many specialty departments and centers, from primary visits to emergency care.

What Awaits You?

• Career growth and development

• Diverse and collaborative working environment

• Affordable and comprehensive benefits package including Tuition Reimbursement

The Revenue Cycle Manger of Clinical Audit and Administrative Appeals is responsible for the development and management of programs related to regulatory reimbursement, including but not limited to the oversight of the Recovery Audit Contractor implementation and Medicaid Integrity Project, and the denial and appeal processes for emergency, outpatient, and inpatient encounters as performed by the Nurses and Claims Analysts for the JHH, JHBMC, HCGH, SMH, SH and ACH. The Manager also has direct responsibility for the Outsource Nurse, Administrative Coordinator and Staff Assistant processes that support RCM and the denial and appeal processes. This position reports directly to the Director of Appeals and Revenue Integrity and provides support for Payor Management and implements the organization’s regulatory reimbursement management plan in accordance with the mission and strategic goals of the organization, federal and state law and regulations, payer requirements and accreditation standards. The Manager also provides other JHM entities support in project planning and implementation along with supervising and recruiting departmental registered nurses.

Take a Tour of Campus: https://www.youtube.com/watch?v=KnNaPzR-AEE

Hours:

Full time (40 hours)

Day Shift, Weekdays

Location:

Johns Hopkins at Keswick

Baltimore, MD

Qualifications:

• Bachelor’s Degree or Associate Degree or Diploma in Nursing from an accredited School of Nursing.
• Requires current Registered Nurse Licensure in the State of Maryland.
• 15 years of direct management experience in an academic health system.
• Excellent knowledge base related to nursing and reimbursement practices, financial and data analysis, third party payer regulations, utilization management standards, case management methodologies, age specific and other regulatory and accreditation requirements related to Care Coordination and cost containment.

Our competitive Benefit Package is designed to support the well-being and financial security of our employees and includes:

• Full medical, dental, and vision plans,
• Retirement plans,
• Paid time off (PTO),
• Tuition reimbursement for you and your dependents,
• Earn up to $1,000 annually for practicing self-care with Healthy @ Hopkins
• Tell a friend and get paid! Ask about our Employee Referral Program Bonus!
• And more! Visit https://jhh.mybenefitsjhhs.com/

Important Notices:

***Effective January 1st 2022, you must be fully vaccinated with an FDA COVID-19 vaccination and provide proof of your vaccination status as part of your occupational health screening. Exceptions to the COVID-19 vaccination requirement may be granted to individuals for religious beliefs or medical reasons by following the proper protocols. Effective 6/1/23, employees at Johns Hopkins All Children’s Hospital, its affiliate locations and Florida State Residents are not required to obtain the COVID-19 vaccine. In the wake of the COVID-19 pandemic, the Johns Hopkins Health System remains committed to providing the highest quality care for our patients and our communities. We encourage you to explore our current opportunities.

***Authorization to Work in the United States: Applicants who require sponsorship now or in the future will not be considered for this position.

Questions for the recruiter? chenley8@jh.edu

JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins!

Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.