Middle Revenue Services Director
Essentia Health
**Job Description:**
The Middle Revenue Services Director provides system leadership, education, and strategic direction for Clinical Documentation Integrity, Physician & APP Advisory and Utilization Management teams. Ensures quality of care meets or exceeds regulatory standards. The Director acts as the liaison to clinical practices and clinicians by providing education and support to better understand documentation and coding guidelines, regulatory/payer requirements and the relationship between documentation, the code assigned, and the effect on compliance, quality, population health initiatives and reimbursement.
**Education Qualifications:**
Key Responsibilities:
+ Designs, implements, and oversees Essentia Health utilization management and clinical documentation integrity (CDI) programs for inpatients and outpatients across all markets
+ Manages operational budget and strategic initiatives
+ Develops, implements, monitors, and drives necessary standards and measurements by establishing key performance indicators (KPIs) internally and measuring against external best practices to ensure optimal outcomes
+ Drives revenue enhancement and cost controls/reduction efforts to achieve Revenue Services fiscal year operational goals
+ Collaborates with regional and site-specific executive leadership to implement and oversee a concurrent Utilization Management (UM) and Clinical Documentation Integrity (CDI) program
+ Builds strong partnerships with internal teams, external consultants, and physicians to drive achievement of UM and CDI goals and performance metrics
+ Works closely with leaders in revenue cycle services, population health, quality, and case management to support and advance organizational strategies and priorities
Education Requirements:
+ Bachelor’s degree in nursing, health information management, business, accounting, finance, or a related field of study
Required Qualifications:
+ 8 years’ experience in Clinical Documentation or Utilization Management or related field
+ 3 years’ experience in leadership of Clinical Documentation or Utilization Management program
Preferred Qualifications:
+ Proven experience within integrated healthcare systems
+ Proficient in Epic, 3M Encoder, Clinical Documentation Integrity (CDI), and Computer-Assisted Coding (CAC) platforms
+ Holds a master’s degree in nursing, health information management, business, accounting, finance, or a related discipline
+ Comprehensive understanding of coding and reimbursement methodologies, including ICD-10-CM/PCS, DRG models, Severity of Illness (SOI), Risk of Mortality (ROM), Value-Based Purchasing (VBP), CPT, HCPCS, APC/APG/EAPG, and Hierarchical Condition Categories (HCCs)
+ Demonstrated expertise in hospital-based electronic health record (EHR) systems, regulatory compliance, coding guidelines, and agency requirements
_This position is open to candidates authorized to work in the United States, with the exception of residents in the following states: California, Massachusetts, New Jersey, New York, Oregon, and Washington. Due to current employment policies, Essentia Health is not able to offer remote employment to individuals residing in these locations._
**Licensure/Certification Qualifications:**
+ Registered Health Information Administrator (RHIA) or Registered Nurse (RN)
+ Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) credential
Employee Benefits at Essentia Health: At Essentia Health, we’re committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.
**Job Location:** Business Service Center
**Shift Rotation:** Day Rotation (United States of America)
**Shift Start/End:** /
**Hours Per Pay Period:** 80
**Compensation Range:** $119080 - $178630 / year
**Union:**
**FTE:** 1
**Weekends:**
**Call Obligations:**
**Sign On Bonus:**
It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.
Confirmar seu email: Enviar Email
Todos os Empregos de Essentia Health