Job Description

Job Description

Job Description

Job Summary

The Director of Revenue Cycle Management (RCM) & Data Integrity is responsible for maximizing revenue and ensuring the integrity, security, and compliance of all healthcare data. This role combines deep data governance expertise with a strong understanding of the healthcare revenue cycle to drive financial performance and regulatory compliance.

The Director of RCM & Data Integrity is a strategic leader who oversees all financial and administrative functions of the revenue cycle and establishes an enterprise-wide data governance framework. This role ensures the organization's data is secure, accurate, and compliant, and that all revenue cycle activities are optimized for efficiency and financial performance. The director will foster a data-driven culture, improve data quality, and ensure compliance with critical healthcare regulations such as HIPAA.

Role and Responsibilities

• Serve as the organization’s primary data analyst: collecting, cleaning, and analyzing data across departments.
• Design, build, and maintain interactive dashboards and reports to support strategic and operational decisions.
• Lead the selection, implementation, and ongoing management of business intelligence (BI) platforms.
• Translate complex data into clear, actionable insights for teams.
• Defining and implementing the RCM data integrity strategy
• Leading relevant committees
• Promoting data integrity principles.
• Establish data ownership
• Manage data dictionaries and metadata
• Implement data quality programs and KPIs.
• Ensure compliance with regulations like HIPAA and manage data risks
• Controlling access to sensitive data
• Oversee the end-to-end revenue cycle, including patient access, billing, coding, claims submission, payment posting, and collections.
• Develop and execute strategic plans for RCM to improve cash flow, reduce accounts receivable (A/R) days, and minimize claim denials.
• Oversee the end-to-end revenue cycle, including patient access, billing, coding, claims submission, payment posting, and collections.
• Oversee the end-to-end revenue cycle, including patient access, billing, coding, claims submission, payment posting, and collections.
• Serves as subject matter expert on current and new EHR & RCM systems.

Qualifications and Education Requirements

A Bachelor's degree in a related field is preferred or 8+ years of progressive leadership experience in healthcare revenue cycle management. Experience developing and implementing data integrity strategies is also required. Proven experience with data integrity frameworks, data quality programs, and knowledge of HIPAA are essential. Experience with RCM and EHR systems, along with strong leadership and communication skills, are also necessary.

Knowledge/Skills/Abilities

• Working knowledge and understanding of regulations pertaining to healthcare compliance.
• Ability to maintain strict confidentiality on all client records and business-related records, as required under HIPAA guidelines.
• Ability to provide an innovative mind set.
• Ability to navigate EMR efficiently and effectively.
• Skilled in exceptional communication, self-motivation, organizational skills, critical thinking, and ability to make good decisions.
• Demonstrates professional behavior reflective of Sanford’s Mission Statement, Philosophy, and Values.
• Must be able to relate well to all kinds of people both inside and outside the organization; builds appropriate rapport; builds constructive and effective relationships; uses diplomacy and tact; can diffuse even high-tension situations comfortably.
• Must possess positive attitude to enhance a cooperative and energetic work environment.
• In-depth knowledge of the entire RCM lifecycle, including patient access, charge capture, and collections.

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift 15 lbs.
• Must be able to perform repetitive tasks such as typing for extended periods of time.
• Must be able to clearly express and exchange ideas by means of spoken word to impart oral information to employees or others accurately or quickly, engaging in sometimes lengthy conversations or presentations.
• Must be able to ascend and descend stairs daily.
• Must be able to seize, hold, grasp, turn or otherwise work with your hand or hands.
• Must be able to perceive sound by ear to interpret oral information from employees or others accurately or quickly.

ADA Disclaimer

The employee must be able to perform the essential functions of the position adequately. If requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship. All requests for accommodations must be made to the Human Resource Department in writing.

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