Sr. Director - Revenue Integrity (Remote)

About the role

The Senior Director of Revenue Integrity is a strategic, systems-oriented leader responsible for enterprise-wide leadership, strategic direction, and oversight of hospital and professional revenue integrity operations across Stanford Health Care and SHC Tri-Valley.

Responsibilities

• Develops organizational strategies for enterprise-wide hospitals and professional revenue integrity, including long-range plans and annual goals.
• Leads policy development for charging, charge capture, validation, charge reconciliation, CDM Governance and documentation integrity.
• Oversees integration of revenue integrity operations across clinical departments, SOM leadership, Patient Financial Services, Office of Compliance & Privacy, HIM, and Coding.
• Serves as a thought leader and change agent, driving innovation, automation, and best practice across the revenue integrity functions.
• Ensures timely, accurate, and compliant completion of all charge capture, CDM maintenance, reconciliations, and revenue validation activities.
• Utilizes Lean, Six Sigma, and process improvement methodologies to optimize workflows and eliminate preventable revenue leakage.
• Serves as the primary liaison for SHC revenue integrity matters to School of Medicine DFAs, Clinical Department Chairs, clinical leadership, and administrative partners.
• Directs preparation of enterprise dashboards, KPIs, business reviews, and executive level reporting.
• Educates hospital and professional revenue generating departments on charge capture requirements, compliance, and CDM practices.
• Oversees governance of the hospital CDM and SOM professional fee schedule to ensure regulatory compliance and revenue accuracy.
• Approves additions, deletions, and modifications stemming from new services, regulatory updates, payor requirements, and clinical changes.
• Ensures alignment between CDM, fee schedules, clinical documentation, and EPIC configuration.
• Led enterprise initiatives to mitigate late charges, preventable denials, claim edit failures, and avoidable under billing.
• Identifies meaningful revenue opportunities using analytics, benchmarking, and auditing.
• Partners with IT, EPIC leadership, Revenue Cycle Optimization and digital innovation teams to enhance revenue impacting workflows.
• Evaluates and integrates AI driven tools for charge capture, audit support, and documentation improvement.
• Ensures staff have the technology, training, and resources needed for optimized performance.
• Leads and mentors a team that may include directors, managers, supervisors, analysts, CDM experts, revenue integrity specialists, and charge capture teams.
• Ensures staffing, succession planning, performance management, and professional development at all levels.
• Fosters a culture of collaboration, accountability, innovation, and high reliability.

Qualifications

• Bachelor’s degree from an accredited college or university with a major in business administration, health care administration, or a related field.
• Master’s degree in a related field.
• 10+ years of progressive leadership experience in hospital and/or professional revenue integrity, charge capture, CDM governance, HIM, Coding, or Revenue Cycle functions.
• 5+ years EPIC experience (HB/PB billing, clinical documentation, charge capture technologies).
• Experience working in an academic medical center.
• Member in Healthcare Financial Management Association or the American Academy of Professional Coders or American Health Information Management Association.

Skills

• Knowledge of all aspects of healthcare revenue cycle functions, including registration, coding and documentation standards, billing and collection processes, as well as government and payer regulations.
• Expert knowledge of CMS regulations, payer requirement, and healthcare reimbursement methodologies, including the data elements associated with the UB-04 and CMS-1500 claim form.
• Advance understanding of medical records, hospital and professional billing, charge description master (CDM) structures, and service item master data.
• Strong understanding of organizational, administrative, fiscal and personnel management principles within complex healthcare environments.
• Ability to conduct and interpret qualitative and quantitative analysis, financial analysis, healthcare economics and business processes, information systems, organizational development, health care delivery systems, project management or new business development.
• Strong organizational skills with the ability to prioritize, manage multiple initiatives, adapt to changing priorities, and operate effectively in a fast-paced environment.
• Ability to provide leadership and influence others.
• Ability to foster effective working relationships and build consensus.
• Ability to mediate and resolve complex problems and issues.
• Ability to develop long-range business plans and strategy.
• Expert level understanding of CDM structure, CPT/HCPCS/ICD coding frameworks, revenue cycle operations, and reimbursement models.
• Comprehensive knowledge of Medicare, Medicaid, and commercial payer rules, claim edits, billing compliance, and regulatory requirements at the local, state and federal levels.
• Proven ability to develop, execute, and sustain and execute organizational strategies across complex health systems.
• Exceptional leadership and influencing skills, with the ability to guide teams, influence senior leaders, and build consensus across diverse stakeholder groups.
• Advanced problem solving skills, including root cause analysis, process redesign, and change management and resolution of complex operational issues.
• Excellent communication, negotiation, and relationship building abilities, with a demonstrated capacity to foster effective partnerships and collaborative working relationships.

Benefits

Base Pay Scale: Generally starting at $100.03 - $132.51 per hour. The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training.