Program Integrity Director Jobs in Ridge, NY (NOW HIRING)

Directs, plans, and organizes revenue cycle information systems activities for the Health System. Collaborates with Information Services and Finance to ensure optimal system-wide best practices. Plans, organizes, and oversees service delivery initiatives involving networking, integration, systems, security, data center, and related vendors in support of various Health System operations, projects and initiatives. Maintains the integrity of various related information systems and facilitates synchronization with the other systems throughout the organization.

Job Responsibility

• Leads a Revenue Cycle group by communicating with and developing staff members, and building consensus for programs and goals that support a business, function or geographic area. 
• Develops and articulates a short-term strategic vision for areas of responsibility.
• Ensures Revenue Cycle meets all financial goals through efficient and effective operations; consistently reviews On-Site operations and Business Office productivity/ production goals and objectives; conducts planned and unscheduled visits to review On-Site operations and Business Office operational efficiency; meets regularly with management to discuss successes, issues, reoccurring problems, and action plans to improve/address them.
• Arranges for periodic management team meetings to discuss problems/ issues with hardware, facility space and general working conditions; reviews monthly and annual status reports addressing key performance indicators, as well as plans for next period; monitors Revenue Cycle's overall financial performance on a monthly basis; keeps abreast of all federal, state and third-party payer rules and regulations; apprises staff.
• Develops and implements annual business plan to maximize Revenue Cycle's revenues; involves On-Site operations and management team in developing annual business plan; closely monitors Revenue Cycle's progress during implementation of business plan; collaborates with management to modify business plan to maximize revenues.
• Schedules overtime to meet projected revenue goals, when necessary; selects, develops, manages, and evaluates direct reports; oversees the selection, development, management and evaluation of indirect reports; identifies and evaluates opportunities to increase clinical practice volume; assists physicians with program implementation to achieve volume and revenue goals.
• Recognizes program expansion opportunities.
• Consistently assists physicians with questions concerning the financial components of their practices; monitors program implementations to ensure that they are achieving expected volume and revenue goals; develops and maintains cooperative quality relationships with physicians; consistently works with physicians to achieve Revenue Cycle goals and objectives.
• Arranges for new physicians to learn about Revenue Cycle's requirements for billing and collections; collaborates with management and physicians to resolve issues/problems in a timely manner and prevent their recurrence; prepares Revenue Cycle annual budget and manages operations within established budget; completes annual budget with designated time frame.
• Involves On-Site operations and Business Office management team in development of annual budget; holds quarterly budget meetings with management to review Revenue Cycle progress in making budget; notifies organization the leadership on a timely basis of budget variances; plans to reduce/eliminate variance; represents Revenue Cycle in industry and professional associations.
• Arranges for important payer newsletters/memoranda to be copied and forwarded for management review and response; presents positive image of organization Revenue Cycle to outside organizations; maintains billing and collection practices consistent with all payer guidelines and reimbursement rules and regulations.
• Guides management in responding to changes in payer guidelines and reimbursement rules and regulations; contacts third-party carries on issues requiring top management's involvement; works with Revenue Cycle staff and management in reacting to changes in the provider community and organizing coalitions to jointly approach third-parties in a unified manner on issues adversely affecting Revenue Cycle.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• Bachelor's Degree required, or equivalent combination of education and related experience.

• 8-12 years of relevant experience and 7+ years of leadership / management experience, required.

Preferred Qualifications

• 5+ years of direct experience leading a Denials Management, Appeals, or Underpayment Recovery team
• Strong knowledge of Medicare and Medicaid programs.
• Strong Epic System proficiency 

*Additional Salary Detail 
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).