Executive Director, Revenue & Payment Integrity

Make it happen at Hopkins!

The Johns Hopkins Health System is seeking a seasoned Executive Director of Revenue and Payment Integrity who will lead the organizations revenue integrity and payment integrity strategy within the Revenue Cycle Management team ensuring accurate capture coding documentation and billing of services to maximize appropriate reimbursement while minimizing compliance risks. This senior leader oversees clinical and financial review programs denial prevention and recovery initiatives coding accuracy charge capture and partnership with clinical HIM coding billing and compliance teams. This leader is also responsible for validating the accuracy of payments by comparing actual payments to expected amounts. Responsibilities include developing and implementing revenue and payment integrity policies and workflows monitoring key performance indicators (revenue leakage denials days in AR coding accuracy) driving process improvement and system optimization and managing staff budgets and cross-functional relationships. The Executive Director serves as a subject matter expert for regulatory and payer requirements leads education and audit programs supports contract and reimbursement analysis and provides executive reporting to ensure sustainable compliant revenue performance. Ideal candidates combine deep clinical or coding knowledge strong analytics and process improvement skills proven leadership in large health systems or managed care environments and a track record of reducing revenue leakage and improving financial outcomes.

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 Childrens Health System Johns Hopkins Community Physicians The Johns Hopkins Medical Services Corporation and Johns Hopkins Medical Management Corporation.

The Executive Director of Revenue and Payment Integrity will:

• Lead the organizations revenue integrity and payment integrity strategy within the Revenue Cycle Management team ensuring accurate capture coding documentation and billing of services to maximize appropriate reimbursement while minimizing compliance risks.
• Oversee clinical and financial review programs denial prevention and recovery initiatives coding accuracy charge capture and partnership with clinical HIM coding billing and compliance teams.
• Develop and implement revenue and payment integrity policies and workflows; monitor key performance indicators (revenue leakage denials days in AR coding accuracy); drive process improvement and system optimization; manage staff budgets and cross-functional relationships.
• Serve as a subject matter expert for regulatory and payer requirements lead education and audit programs support contract and reimbursement analysis and provide executive reporting to ensure sustainable compliant revenue performance.

QUALIFICATIONS:

• Bachelors degree in healthcare administration finance business administration or a related field (required) and

• Masters degree in healthcare administration finance business administration or a related field (preferred)

• 10 years of experience in revenue cycle management (required) including 5 years of management experience with significant business impact (required)

• Depending on individual position assignment additional certifications may be required

• Navigate rapidly changing situations from evolving patient needs to technological advancements by remaining flexible continuously learning embracing new challenges and quickly recovering from setbacks.

• Excellent written and verbal communication skills with an emphasis on confidentiality tact and diplomacy.

• Applies advanced technical knowledge to solve complex matters within a network function or across multiple business units.

• Makes decisions and recommendations on issues affecting a department or functional area.

• Strong attention to detail and self-directed approach to consistently ensure data integrity and accuracy.

• Upholds ethical principles by maintaining confidentiality ensuring informed consent and making decisions that prioritize the well-being of both patients and staff.

• Authority to direct and support employees daily work activities; has direct responsibility for hiring termination corrective action and performance reviews.

• Works seamlessly within diverse teams bringing together professionals from various disciplines to provide patient-centered care and achieve collective goals.

• Identifies control objectives for the designated function and implements cost-effective controls designed to meet those objectives.

• Makes independent decisions related to products services implementing new programs and supporting technical/operational processes of a network or business unit.

• Addresses problems that are highly varied complex and often non-recurring requiring higher-management input and often determining new processes or procedures.

• Applies advanced understanding of discipline/specialization prior supervisory experience and advanced interpersonal and communication skills in back-end revenue cycle management.

• Develops and is accountable for the budget of a work department office or unit.

• Leads business process improvement for the designated area.

• Performs costbenefit analyses for the designated area.

• Advanced proficiency and experience using Microsoft Office (Excel PowerPoint Word Outlook).

Salary Range: Minimum 214102.00/annually - Maximum 261178.00/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 an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity and expression age national origin mental or physical disability genetic information veteran status or any other status protected by federal state or local law.

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