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Department:  Business Services
Status:  Full Time
Shift:  1st

The Revenue Integrity Manager is responsible for the leadership of the Revenue Integrity department for Hoag Clinic. The Revenue Integrity Manager works in partnership with the revenue cycle department, and coding/auditing compliance to facilitate the best standard methodologies in coding, documentation, charge capture and compliance for all of Hoag clinic providers. The Manager will supervise the Revenue Integrity team, which is responsible for ensuring the highest level of efficiency, integrity and compliance. The team is tasked with improving the efficiency of patient net revenue realization and minimizing revenue leakage across the system. This involves complete capture of patient revenue in every area that generates charges, strategic pricing, denials management, and clinical operations relations. Furthermore, this position will also be responsible for accurate collection and recording of HMO revenue. Performs other duties as assigned.


Job Knowledge, Skills, and Competencies

  • Diversity - Ability to work with a diverse group of people in a manner that enables them to reach their full potential, in pursuit of organizational objectives, without anyone being advantaged or disadvantaged by irrelevant considerations.
  • Equipment Knowledge – Knowledge of equipment, tools, technology and other devices in work area and the ability to use them to the extent required for the job. For clinical position this includes equipment and devices pertinent to treatment, procedures and practice.
  • Job Knowledge - The knowledge and understanding of concepts and procedures needed to be successful in the job. For clinical positions, this includes clinical procedures required by department and unit, as demonstrated by unit-based competency testing. (formerly Process Knowledge)
  • Interpersonal Skills - Listens to and understands what others are saying. Establishes effective working relationships with others, contributing to a climate of mutual respect and cooperation. Uses vocabulary and grammar appropriate to the situation. Demonstrates sensitivity and tact, understanding own effect on the motivation, attitudes and actions of others. Makes favorable first impressions.
  • Leadership – Exercising supervisory responsibility in a manner that is thoughtful and respectful. Creating an environment and providing information so that team members are successful. A leader formulates vision and objectives and leads team members in successfully achieving them. Promoting the highest standards of ethics and compliance.
  • Operational Management - the management of the people, resources, deliverables, budgets, general administration and other components of day-to-day management of a functional unit or department.
  • Oral/Written Communication - Ability to speak and write effectively, demonstrates fundamental command of language, communicates well using all mediums.
  • People Management - People Management is the interaction, communication, relationships and dealings with staff members, and the style in which those interactions take place. It includes the development of employees and work places that are inclusive.
  • Project Leadership - Project Leadership is a process of stating objectives in a way that is precisely understood, ensuring the commitment of individuals to those objectives, defining the methods of measurement, and getting things done.
  • Travel – Position may require local travel between various Organization locations.


Organization Behavioral Competencies

  • TRUST & ACCOUNTABILITY: Demonstrates honest and ethical behavior. Takes responsibility for both words and actions. Acts with integrity. Maintains patient confidentiality.
  • BUSINESS ACUMEN: Uses resources, equipment and finances appropriately. Demonstrates the functional and technical skills to do the job effectively. Willing and actively shares his/her knowledge with others. Accepts changes and adapts to new situations and responsibilities.
  • CUSTOMER SATISFACTION: Delivers superior customer service consistent with the Hoag Experience. Displays a professional image. Demonstrates tact, diplomacy and understanding when dealing with difficult situations. Listens and asks questions to understand patient and customer needs. Builds relationships with internal customers and employees. Admits mistakes and takes service recovery to steps to ensure any issues or problems are quickly addressed. Ensures that all information and services provided are safe, accurate, and available in a timely manner and meet regulatory requirements.
  • INNOVATION: Brings forth creative ideas (one’s own or others) to address patient, physician, customer, and community needs. Looks for creative or new ways to improve efficiencies and reduce costs. Adopts new processes, techniques and methods. Stays current with technologies and advances in his/her area, department and/or field.
  • INSPIRING LEADER & COACH: Fosters energy, enthusiasm, commitment, and an environment where people want to excel. Demonstrates respect for diversity in people, ideas, and backgrounds. Aligns actions with Hoag’s Mission, Vision, and Values. Maintains positive relationships with Hoag’s physician partners and practices mutual respect between hospital staff and our physician partners. Provides feedback in a way that facilitates improvement and growth. Delegates responsibilities to build team capability and manage workload. Is someone people like working WITH and FOR
  • TALENT DEVELOPMENT: Selects and grows talented individuals. Empowers others with the authority they need to be successful. Identifies and supports developmental initiatives and opportunities. Takes time to mentor and support direct reports. Recognizes and rewards people for excellent performance.
  • STRATEGIC AGILITY: Anticipates future trends and consequences. Provides clear direction to his/her team. Works through formal and informal channels to get things done. Accurately anticipates and addresses both potential threats and potential opportunities that may impact the department/function's success. Accepts change and adapts to new situations and responsibilities.


Education and Experience

  • Associate’s Degree minimum requirement. Bachelor's degree in Business, Finance, Healthcare or related field preferred.
  • Five (5) years of experience with revenue cycle operations management

Nearest Major Market: Orange County
Nearest Secondary Market: Los Angeles

Job Segment: Compliance, Revenue Management, Law, Revenue, Clinic, Legal, Finance, Healthcare

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