Director Payer Contracting & Revenue Integrity

The Director, Payer Contracting & Revenue Integrity reports directly to the Vice President, Revenue Cycle & Managed Care and is responsible for coordinating and executing payer contracting strategies and functions, as well as revenue integrity programs. This position is responsible for the negotiation and management of payer contracts that meet the financial, operational and strategic goals of Valley Children’s Healthcare.  The director is responsible for developing and maintaining productive payer relationships; negotiating hospital and hospital-based provider contracts; and ensuring contract performance goals are met. This position acts as the primary lead for all payer relations at Valley Children’s Healthcare. This position directs all revenue integrity functions including charge capture audits, charge master maintenance, performance improvement, as well as analysis and reporting for executive-level decision support.  The position ensures organizational compliance with all regulatory billing guidelines.

Must have a broad based knowledge of hospital and medical group operations.  Must maintain expert knowledge of the managed care industry and its application in a hospital setting.  Must have knowledge of hospital and medical group contract management and financial information systems.