Director Revenue Integrity, Coding & Strategic Pricing

Step into a high-impact leadership role where your expertise directly drives financial strength, compliance, and innovation across a dynamic health system. The Revenue Integrity Director plays a critical role in providing strategic direction and oversight of various revenue cycle functions to safeguard the integrity of the organization's revenue within the health system. This encompasses revenue optimization, prevention of revenue leakage, and direction and oversight related to charge capture, charge reconciliation, professional coding functions, and other reimbursement matters. The role extends to providing guidance on compliant, transparent, and defensible pricing for both new and existing services, as well as reporting and analyzing revenue-related data. Additionally, the Director supports revenue-related process improvement initiatives and provides oversight and direction for the charge description master and physician fee schedules.

The Johns Hopkins Health System Corporation is a not-for-profit organization dedicated to providing the highest quality of care in the treatment and prevention of human illness. JHHS is an academically based health system consisting of: The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Johns Hopkins Howard County Medical Center, Suburban Hospital, Sibley Memorial Hospital, The Johns Hopkins All Children’s Health System, Johns Hopkins Community Physicians, The Johns Hopkins Medical Services Corporation and Johns Hopkins Medical Management Corporation.

QUALIFICATIONS
Education & Experience:

• Bachelor’s degree required, preferably in business or healthcare; Master’s preferred
• Minimum of 10+ years of progressively responsible related experience in professional and hospital
  coding and/or clinical documentation experience, healthcare, finance, revenue integrity, revenue
  cycle operations, accounting or related field.
• Two years related to hospital and physician revenue
  integrity work.
• 5-7 years of management experience with significant business impact

Knowledge, Skills & Abilities:

• Experience with a progressive focus on charge to payment relationships and patient account
  functions and understanding of healthcare financing and reimbursement mechanisms (DRGs, EAPGs, CCI, MUE)
• Experience with clinical documentation and coding, including strong knowledge around CPT, HCPCS, ICD10-CM/PCS, revenue codes and code assignment
• Strong quantitative, analytic and problem-solving skills,
• Advanced use of Excel (i.e. sorting, pivot tables, graphs, etc.).
• Ability to plan, develop, and present data/materials to an audience, including senior leaders and executives
• Strong organizational skills to handle multiple priorities of highly detailed information
• Strong communication skills both written and verbal
• Strong understanding of laws and regulations as they pertain to coding, billing, and pricing
• transparency
• Requires excellent interpersonal skills in dealing with subordinates, co-workers, hospital staff, patients, and payer representatives.
• Requires proven analytical ability and organizational skills necessary to organize/assess information and provide timely recommendations based on data analysis.
• Must possess excellent verbal and written communication skills to support interaction and participation in meetings with patients, physicians, payer representatives, MHA, and representatives of other departments within our organization (Medical Records, Utilization Review, JHMCIS, registration, etc.).
• Requires leadership and mentoring skills necessary to provide support to work group and promote employees.
• Managerial abilities necessary to motivate and control the activities of a large production unit.
• Analytical skills necessary to comprehend complicated issues and formulate creative solutions.
• Synthesize large data sets and summarize for large and diverse audiences.
• Requires strong customer service skills and a customer-centered approach to leadership.

We’re proud to offer a robust benefits package that supports your health, growth, and well-being. Discover our full offerings and costs here: mybenefitsjhhs.com 

What Awaits You: 

• Competitive pay and benefits that support you at every stage of your life and career. 

• Retirement plans with employer contributions to help you plan confidently for the future. 

• Generous time off so you can unplug, recharge, and enjoy life outside of work. 

• Access to world-class facilities and innovative technology that fuel your curiosity. 

• Endless opportunities to advance your career as part of the Johns Hopkins team

Salary Range: Minimum 155,454.00/annually - Maximum 190,000.00/annually. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

The Hospital reserves the right to modify employee schedules as needed.

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.