Reporting to the Director, Revenue Integrity, the Manager, Revenue Reporting & Analytics, is responsible for improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation.
Revenue Integrity (RI) is a distinct function that drives proactive charge capture opportunity identification and realization. In addition to revenue enhancement, RI also serves to provide focus toward revenue protection and maintenance.
The Manager, Revenue Reporting & Analytics, role in the Revenue Integrity Model is to manage the RI Analytics team and drive performance using strategic methodologies surrounding data and technology solutions to improve charge capture. Solutions may include a systems development component, development of new reports, analysis of data, synthesis of raw data into actionable information, and/or recommendations and implementation of process improvements or organizational change. This methodology includes management of revenue reconciliation, charge capture assessments and interventions/implementation of opportunities.
Responsibilities include initiation, planning, execution, control and completion of projects and work processes in accordance with the Revenue Integrity strategic plan, and Business Unit and HFHS goals and objectives. The Manager, Revenue Reporting & Analytics, manages the work of RI Principal Specialists, RI Senior Specialists, RI Specialists, RI Principal Analysts, RI Senior Analysts and RI Analysts. This position relies on extensive experience and disciplined judgment to plan and accomplish RI initiatives. With responsibility for understanding complex clinical departments and practices, at each Business Unit and throughout HFHS, acts with a high degree of autonomy, manages various projects and education/training focusing on revenue cycle integrity. Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills and well-developed analytic and organizational skills.
Project work may include technical analyses or may require facilitation of a large multidisciplinary group of administrators and/or physician leaders, including collaboration with supervising/teaching physicians in an academic environment. Works collaboratively with leadership to increase efficiencies, reduce variability, reduce errors/defects, reduce organizational and compliance risk and involve all appropriate revenue cycle personnel. Prepares presentations, reports and recommendations for management and coordinates implementation of findings. Serves as a technical consultant to other HFHS departments. Communicates regularly with Management on specific projects. Flexibility, innovation, and creativity are necessary characteristics of the Manager, Revenue Reporting & Analytics. The Manager, Revenue Reporting & Analytics is expected to continuously learn and to spread successful innovation throughout the institution.
PRINCIPLE DUTIES AND RESPONSIBILITIES:General:
Strong Leadership skills. Works with senior System and/or Business Unit leadership, department leaders and physician leaders to formulate strategies to identify revenue integrity opportunities and initiatives. Leads improvement initiatives using various work processes, tools, procedures and methodologies including data analytics, financial analysis, process improvement methods and other problem solving approaches.
Skilled and knowledgeable on ways to collect, organize and generate various analyses on more complex problems and processes. Able to achieve action and value from ambiguous, imperfect data systems and processes. Able to explain and teach others how to interpret various data pulls and sample results and utilize this information to identify areas to target for improvement initiatives and/or to perform root cause analyses.
Demand Management expertise, including 1) requirements gathering, 2) prioritization, 3) agile feedback and iterative development and 4) communication.
Strategic vision, forward focus on upcoming industry trends in both Health Care and data analytics, including EPIC’s related near term strategy and development roadmaps that may inform and/or influence the strategies of HFHS.
Researches best practices, including implementation of new products or systems, for Revenue Integrity initiatives and appropriately incorporates identified practices into process design.
Develops and maintains collaborative working relationships with administrative and physician leaders in revenue producing departments, information systems personnel and clinical areas. Develops relationships with physicians throughout the organization. Acts as a business partner with physicians, both in clinical and academic areas.
Other duties as assigned.
Responsible for planning, directing, and evaluating assigned employees as they provide Revenue Integrity services to Business Units and HFHS departments.
Assigns, distributes, reviews work assignments ensuring timely and accurate completion. Monitor deadlines.
Identifies internal staff development needs and opportunities for improvement or enhancement of staff skills.
Responsible for the quality of services provided to Business Units and HFHS departments.
Responsible for leadership and development of assigned Revenue Integrity staff, including the identification of internal and external development opportunities to enhance the skills offered to HFHS customers.
Interviews job applicants for department vacancies, hires, recommends pay increases, and recommends discipline and termination of assigned personnel as warranted. Prepares mid-year and annual performance appraisals for all assigned staff.
Responsible for continuous improvement surrounding Employee Engagement and Employee Satisfaction.
Plans and manages department resources including developing a department budget. Performs resource planning and scheduling of department personnel to ensure customer requirements are met.
Revenue Reporting & Analytics
Develops policies and procedures to improve accuracy and completeness of clinical charge capture for both facility (hospital) and professional revenue. Provides education and training to revenue producing departments and RI staff.
Works with organizational leadership in assessing, redesigning, and maintaining charge capture and clinical documentation processes as changes in reimbursement from third party payers occurs.
Develops and maintains collaborative working relationships with revenue producing departments, information technology personnel, health information management and coding to include a forum for continuous overall process improvement and feedback.
Monitors and evaluates the organizational charge capture performance to maintain cash flow and data integrity.
Supports clinical documentation improvement initiatives and training to support accurate billing and coding processes to improve reimbursement.
Demonstrates knowledge of clinical documentation requirements to identify documentation opportunities to support various payor contractual provisions.
Strong financial analysis and financial accounting skills.
Consults with Compliance on regulatory risk.
Maintains current working knowledge of federal and state regulations regarding the revenue cycle. Maintains knowledge of contract provisions in other third party managed care contracts. Provides subject matter expertise to Finance/Reimbursement to ensure data validity and accuracy in payor reimbursement models.
Manages RI Project Portfolio, prioritizes and manages with agility and responsiveness.
Develops project scope and project work plan including the gathering of information, estimates of resources required, estimated timelines for completion, background, project objectives, description of proposed approach, deliverables, and a customer communication plan.
Reviews project plan with key stakeholders and customers to obtain commitment and engagement with project initiatives and objectives.
Assists staff with the development of project planning and initiatives relative to charge capture to include remediation of audit findings & recommendations, new service lines or business and other enhancement projects.
Develops process performance metrics. Measures actual results to estimated results to validate net revenue impacts. Provides expertise and tools to managers, leaders, etc. to develop and sustain process improvements.
For RI projects and initiatives, consistently incorporates the assessment of the culture and workplace environment and teaches assessment tools to others.
Bachelor’s Degree Required. A degree in Business Administration, Healthcare Administration, Engineering, Computer Science or related field. Master’s Degree, preferred.
Significant project management experience and outstanding analytical, communication and interpersonal skills are required.
Minimum of 5-7 years of Healthcare management experience, project management or consulting experience, required.
Minimum of 3-5 years Hospital or Large Physician Practice Management experience preferred.
Data Analytics management experience, preferred. Revenue Cycle management experience, preferred.
Experience/training in process improvement disciplines (i.e., LEAN, Six Sigma, etc.), preferred.
Excellent oral and written communication skills, including the ability to teach complex technical/analytical concepts to System leadership, management and staff.
Experience in the use of a structured query language (SQL) in a relational database.
Experience in the use of HFHS Corporate Data Stores a plus.
Professional experience in the use of a programming language also a plus
EPIC Clarity certification, preferred.
Ability to develop strong working and collaborative relationships with physician leaders in clinical and academic settings.
Knowledge of Medicare, Medicaid, Medicaid OPPS reimbursement, and other 3rd party billing rules/coverage.
Financial analysis and financial accounting skills.
Excellent analytical, motivational and critical thinking skills.
Ability to manage large, complex, simultaneous assignments with potentially conflicting priorities and deadlines. Proven project management skills.
Sound decision making skills.
Strong diplomacy and collaboration skills.
Strong knowledge of Microsoft Office, particularly Excel. Strong, growing base of analytical/technical, facilitative and process improvement knowledge. Expertise in data base and project management applications a plus.
The ideal candidate will have experience in gathering and organizing data from disparate sources and presenting findings to leadership in a way that is useful for decision support, benchmarking, and quality performance tracking.
The ideal candidate will be comfortable in communicating alternative ideas with clinicians related to information options and solutions.
Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health
care systems, is a national leader in clinical care, research and education. The system includes
the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health
insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory
network and many other health-related entities throughout southeast Michigan, providing a
full continuum of care. In 2015, Henry Ford provided $299 million in uncompensated care.
The health system also is a major economic driver in Michigan and employs more than 24,600
employees. Henry Ford is a 2011Malcolm Baldrige National Quality Award recipient. The
health system is led by President and CEO Wright Lassiter III. To learn more, visit HenryFord.com.
Whether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Henry
Ford Health System has a new approach for its employee benefits program - My Choice
Rewards. My Choice Rewards is a program as diverse as the people it serves. There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness
and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other
benefits and services. Employee's classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is
committed to the hiring, advancement and fair treatment of all individuals without regard to
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