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Revenue Integrity Program Manager
Revenue Integrity Program ManagerVivent Health • Highland Park, MI, US
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Revenue Integrity Program Manager

Revenue Integrity Program Manager

Vivent Health • Highland Park, MI, US
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Revenue Integrity Program Manager

Get ready for something amazing! Imagine this : generous paid time off, including 12 paid holidays. And that's just the start of the incredible perks you'll enjoy at Vivent Health. There is 401k with 100% employer match up to 5%, 12 weeks of fully paid parental leave, employer subsidized medical, dental, vision benefits, and gender-affirming care benefits. And that's not even scratching the surface. Our complete package also includes employer paid short and long-term disability, tuition reimbursement, certification, and licensure assistance, and so much more. We also offer benefits for part-time roles!

But here's the real deal. Your journey with Vivent Health isn't just a job. It's a chance to join an organization dedicated to fostering a workforce that reflects diverse backgrounds, perspectives, and experiences. This makes you a part of something bigger and enables you to have a meaningful impact in our communities and the lives of the amazing patients we serve.

Here are a few highlights of what working at Vivent Health may offer you :

  • Equity Practices : Fair treatment, access, and opportunities for all employees, creating an environment where everyone feels valued, respected, and empowered to contribute.
  • Professional Growth : Opportunities for professional development and advancement, along with training programs and events that promote cultural competence, unconscious bias training, and awareness.
  • Collaboration on an inter-disciplinary team : Within our integrated HIV care and prevention model, we employ a high level of collaboration across disciplines. That means that, in your role, you will have the opportunity to be exposed to whole person-care across medical, behavioral health, pharmaceutical, research, and more!
  • Delivery of quality patient care : Our integrated HIV care and prevention model is proven to help patients achieve positive health outcomes.

The Revenue Integrity Program Manager is a strategic leader responsible for optimizing professional revenue through CDM maintenance, contracting and pricing strategy, coding education, clinical documentation audits, and payor enrollment. With strong analytical and communication skills, the Program Manager drives education, reporting, and productivity reviews that support financial sustainability and operational excellence. This position will routinely work in cross-functional collaboration, with patient access, billing office, clinical departments, compliance, and analytics teams to ensure accurate billing, regulatory adherence, and continuous improvement.

Winning skills and behaviors for success :

  • Manage contracting and pricing strategy for all Vivent Health clinical locations.
  • Provide oversight to payor enrollment team ensuring timely enrollment.
  • Conduct prospective and retrospective clinical documentation audits of charge capture practices and report findings.
  • Provide education to providers and charge capture support staff which includes CPT, HCPCS, revenue codes, and modifiers by payor and region.
  • Coordinate charge capture improvement tools.
  • Evaluate and maintain the system Charge Description Master (CDM) for compliance and consistency.
  • Lead projects to improve revenue capture and reduce provider burden.
  • Identify and resolve charging issues using EPIC work queues and external platforms.
  • Provide ongoing reporting and presentations to clinical and executive leadership.
  • Facilitate Revenue Integrity meetings.
  • Leadership is the ability to inspire, influence, and guide others towards achieving a common and / or strategic goal or vision. It involves several key elements :

  • Vision and Direction : A leader has a clear idea of where they want to go and communicates this vision effectively to others.
  • Motivation : Leaders inspire and motivate their team members, encouraging them to give their best effort and stay committed to the goals.
  • Decision Making : Effective leaders make informed decisions, often considering input from their team while taking responsibility for the final choices.
  • Communication : Communication skills are crucial for leaders to articulate their vision, provide feedback, and foster collaboration among team members.
  • Empathy and Emotional Intelligence : Leaders understand and relate to the emotions of others, building trust and creating a positive work environment.
  • Accountability : Good leaders take responsibility for their actions and decisions, setting a standard of accountability for themselves and their team.
  • Adaptability : In a dynamic environment, leaders must be flexible and adaptable, adjusting strategies and approaches as needed to achieve success.
  • Collaboration : Leaders model collaboration, engage teams and drive partnerships across departments to transfer knowledge, enhance decision-making and improve results.
  • Required and preferred knowledge and experiences to succeed :

  • Education : Bachelor's degree in a related field from an accredited college or university (or equivalent combination of education / experience).
  • Leadership : 2+ years of supervisory experience.
  • Work Experience : 5+ years of progressively responsible work experience in revenue cycle operations.
  • Technical Experience : Proficient in health care and professional revenue cycle operations. Expert in revenue data analysis and reporting. Knowledge of coding conventions and third-party payer rules. Experience with Epic Care, Epic Resolute, and related interfaces.
  • Soft Skills : Strong interpersonal and communication skills. Ability to influence decision-making through data-supported insights. Critical thinking and problem-solving abilities. Ability to facilitate stakeholder meetings and manage multiple priorities.
  • Additional Preferred Qualifications : COC, CPC-H, CCS, CPC, CCSP, RHIT, or RHIA certification preferred. HIV experience in a not-for-profit environment.
  • Statement of Inclusion :

    Vivent Health is an equal opportunity employer and will recruit, hire, promote, and transfer qualified persons into all job classifications regardless of race, gender, religion, skin color, national origin or ancestry, physical disability (including pregnancy), mental disability, age, gender identity, sexual orientation, legally protected medical condition, family care status, marital status, veteran status, genetic characteristics, or any other characteristic protected by federal or state law. Vivent Health complies with other expanded protected classifications that specific county or municipal regulations may mandate.

    Vivent Health is deeply committed to fostering respect, dignity, and understanding for all individuals affected by HIV, regardless of race, ethnicity, sexual orientation, gender identity, socioeconomic status, or any other characteristic. We are dedicated to cultivating a supportive and inclusive environment that champions advocacy, education, and compassionate care for everyone in our diverse community.

    Going beyond the law's requirements, Vivent Health places great importance on fostering a culture that celebrates diversity, equity, inclusion, and belonging. We actively seek qualified candidates from different racial, cultural, and economic backgrounds, as we believe that differing perspectives and experiences make us stronger as an organization. Vivent Health encourages all interested persons to apply for this position, and we look forward to learning more about your unique background and qualifications.

    As a recipient of federal funding, Vivent Health will not hire nor enter a contractual relationship with any party debarred, suspended, or excluded from federal assistance programs.

    Salary : Starting at $85,000K / annually (Depending on Experience)

    Public Student Loan Forgiveness : Employment at our organization may qualify you for federal student loan forgiveness programs. We do not directly pay for nor forgive federal student loans; however, our status as a not-for-profit organization under Section 501 (c) (3), makes us an eligible employer. There may be other determining factors for one to qualify.

    Please follow this URL to review one such program and their requirements :

    https : / / studentaid.gov / manage-loans / forgiveness-cancellation / public-service

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