Job Summary:
MaineGeneral Health is seeking an experienced and strategic Revenue Integrity Manager to lead departmental operations and oversee initiatives that support accurate reimbursement, revenue optimization, and financial performance across the organization.
This role is responsible for developing and implementing strategies that strengthen revenue integrity, improve financial processes, and ensure compliance with regulatory requirements and payer guidelines. Working collaboratively with clinical, financial, and administrative leaders, the Revenue Integrity Manager provides oversight of charge capture, Charge Description Master (CDM) maintenance, billing and reimbursement analysis, and other revenue optimization initiatives.
The ideal candidate brings strong leadership, financial and analytical expertise, and a comprehensive understanding of healthcare revenue cycle operations. This position offers an opportunity to influence organizational financial performance while driving sustainable improvements that support MaineGeneral Health's long-term goals.
Job Description:
Lead the daily operations of the Revenue Integrity department, ensuring alignment with departmental goals and broader organizational objectives.
Partner with leadership to establish departmental goals, performance standards, operational strategies, and long-term improvement initiatives.
Direct revenue integrity programs and financial optimization strategies designed to improve reimbursement accuracy, maximize revenue, and support organizational financial health.
Establish performance benchmarks, monitor key performance indicators, and use data analytics to identify trends, opportunities, and areas for improvement.
Provide direct oversight of charge capture integrity, Charge Description Master (CDM) maintenance, and billing and reimbursement analysis.
Monitor payment variances, reimbursement trends, and potential revenue risks, developing strategies to address discrepancies and improve financial outcomes.
Ensure departmental operations and revenue integrity processes comply with applicable regulatory requirements, payer guidelines, contractual agreements, and organizational policies.
Oversee staff management and development, including recruitment, performance evaluations, scheduling, payroll, employee engagement, and conflict resolution.
Promote a positive and productive team environment that encourages professional development, accountability, and employee satisfaction.
Manage departmental budgets, vendor relationships, and resource allocation to ensure operational effectiveness and financial responsibility.
Evaluate equipment, staffing, and resource needs; develop recommendations and justify capital and operational expenditures as appropriate.
Collaborate with clinical, financial, and administrative departments to strengthen revenue processes, improve communication, and implement sustainable solutions.
Lead special projects, organizational initiatives, and strategic programs as assigned by leadership.
Utilize data analytics, payer requirements, and industry standards to identify opportunities for revenue improvement and strengthen organizational compliance.
Qualifications:
Experience in healthcare revenue cycle management, revenue integrity, reimbursement, or healthcare financial operations.
Demonstrated leadership experience, including staff supervision, performance management, and team development.
Strong understanding of healthcare reimbursement methodologies, payer requirements, billing processes, and regulatory compliance.
Knowledge of charge capture processes, Charge Description Master (CDM) maintenance, and revenue integrity practices.
Experience analyzing financial data, payment variances, reimbursement trends, and operational performance metrics.
Strong financial management skills, including budgeting, resource allocation, and expense oversight.
Ability to develop and implement operational strategies, performance improvement initiatives, and…