Director of Revenue Management

Director of Revenue Management | University of California San Francisco

The Director of Revenue Management directs all UCSF Health revenue integrity strategy and initiatives across hospital and professional billing environments. The Director oversees the Revenue Integrity (RI) team and has enterprise responsibility for Charge Description Master (CDM) governance, pricing, accurate and compliant charge capture, documentation alignment, revenue monitoring, and proactive identification and mitigation of denial risk. Responsibilities include the structure and maintenance of the CDM and professional fee schedules; development, implementation, and oversight of policies and processes related to compliant charging and coding practices; pricing strategy, analysis, and modeling; and proactive monitoring of gross revenue performance and revenue risk. The Director collaborates extensively with clinical departments, Health Information Management, Patient Financial Services, Compliance, Internal Audit, Health Plan Strategy, Finance, and Information Technology teams to ensure revenue integrity requirements are embedded into operational and technical workflows. This includes partnership with IT and Epic application teams to optimize system design, automation, testing, and validation of charge capture and billing workflows to ensure accuracy, efficiency, and safeguarding of revenue. The Director interacts with executives, other directors, internal and external auditors, compliance leadership, operational leaders, physicians and their staff, and UC system counterparts. External contacts include state and federal agencies, regulatory bodies, vendors, and external auditors. The Director contributes to short- and long-range planning for revenue cycle strategies, processes, tools, and systems; establishes departmental goals, budgets, and staffing plans; and develops policies that affect revenue integrity and revenue cycle functions across UCSF Health. Errors in judgment or failure to achieve objectives may result in significant financial loss, compliance risk, or operational disruption.

The salary range for this position is $144,200 - $350,000 (Annual Rate).

Required Qualifications

• Bachelor's degree in relevant field such as, Business, Management, or Health Administration; or equivalent experience
• Ten (10) years of experience in hospital and professional revenue cycle leadership, charge description master maintenance, clinical charge capture, coding, government/third-party reimbursement, or similar healthcare experience
• Possession of 1 or more of the following certifications:
  • CPAM – Certified Professional in Ambulatory Management (MGMA)
  • CHRI – Certified Healthcare Revenue Integrity (AAPC)
  • CHC – Certified in Healthcare Compliance (HCCA)
  • CPC – Certified Professional Coder (AAPC)
  • CCS – Certified Coding Specialist (AHIMA)
• Experience in managing and/or developing charge description master, fee schedules, and charge capture processes, policies, and/or procedures
• Practical experience using hospital information systems, Epic preferred, and computer proficiency with PC applications (e.g. Microsoft Office)
• Practical experience and knowledge of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and Revenue codes
• In-depth knowledge of overall revenue cycle processes, specifically revenue integrity, including industry trends
• Demonstrated leadership experience in a healthcare setting, preferable within a medical facility or health system
• Knowledge of applicable laws, regulations, requirements, standards and practices pertaining to patient confidentiality and information management
• Demonstrated analytical and decision-making skills
• Demonstrated professional interpersonal and communication skills
• Excellent organizational, time management, and project management skills; ability to manage multiple, competing priorities
• Detail-oriented, good organizational skills, and ability to be self-directed
• Ability to present to and interact with all levels of hospital management and physician leaders
• Ability to plan, document, direct, monitor and coordinate workflows

Preferred Qualifications

• Master's degree in related health care or business area and/or equivalent experience/training