Manager Revenue Integrity, System Charge Description Master

The Manager, Revenue Integrity/System Charge Description Master, is responsible for the accuracy and integrity of the Henry Ford Health Professional and Facility Charge Description Masters (CDM) to ensure accurate charge capture and compliance with all regulatory and third-party payer requirements. The Manager, Revenue Integrity/System Charge Description Master is responsible for leading the Revenue Integrity (RI)/CDM Team in designing, developing, and implementing robust and sustainable charge capture solutions to drive revenue cycle results across the health system. This position will work with Henry Ford Health stakeholders to understand and address key charge capture challenges in clinical and operational areas. Responsibilities include maintenance of the Henry Ford Health Professional and Facility Charge Description Masters and charging policies and procedures that support compliant charging processes. Works in concert with other Revenue Cycle teams, Finance, Reimbursement, Compliance and Contracting on the distribution of and compliance with third party payer coding and billing requirements. The Manager, Revenue Integrity/System Charge Description Master, is responsible for ensuring all EPIC CDM build and maintenance requirements are met and works with other HELIOS teams to meet all HELIOS/EPIC requirements, including EPIC upgrades, build for Henry Ford Health strategic initiatives, new services/locations, Go-Lives and HELIOS requirements, including deadlines, mandatory response times, representation on various HELIOS calls, WQs and tickets. Initiation, planning, execution, and completion of RI/CDM projects and work processes in accordance with Henry Ford Health goals and objectives is also a responsibility. The Manager must understand complex revenue cycle, clinical, and operational practices and acts with a high degree of autonomy in managing projects, routine responsibilities, and overall team capacity. Due to its service focus, the Manager possesses strong interpersonal, presentation, and communication skills and well-developed technical and organizational skills. Project work may require facilitation of a large multi-disciplinary group of senior leaders, administrators and/or physician leaders. The Manager utilizes various process improvement methodologies to facilitate identification and determination of needed changes for people, process and/or technology. Critical thinking, problem solving, analytical skills, relationship building, flexibility, innovation, and creativity are necessary characteristics of the Manager, Revenue Integrity/System Charge Description Master. The Manager is expected to continuously learn and to spread successful innovation throughout Henry Ford Health.

1.  Works with senior System and/or Business Unit leadership, department leaders and physician leaders to formulate strategies to identify charge capture opportunities and initiatives. Leads improvement initiatives using various work processes, tools, procedures, and methodologies including data analytics, process improvement methods and other problem-solving approaches.

2.  Skilled and knowledgeable on ways to collect, organize and generate various analyses on more complex problems and processes. Able to explain and teach others how to interpret various data pulls and sample results and utilize this information to identify areas to target for improvement initiatives and/or to perform root cause analyses. 

3.  Research best practices, including implementation of new products or systems, for Revenue Integrity/CDM initiatives and appropriately incorporates identified practices into process design. 

4.  Develops and maintains collaborative working relationships with administrative and physician leaders in revenue producing departments, information systems personnel and clinical areas. Develops relationships with physicians throughout the organization. Acts as a business partner with physicians, both in clinical and academic areas. 
5. Provides consulting advice to Henry Ford Health leaders, administrators, and providers. Provides education to Clinical and Administrative Leaders, Providers and Ambulatory Staff. 
6. Subject Matter Expert in Henry Ford Health charging, coding and EPIC functionality. 
7. Manages, mentors and coaches team members, actively leads employee engagement and supports team member professional development. 
8. Ensures Henry Ford Health charging policies and CDM are compliant with all federal and state regulatory requirements.

9.  Actively participates in CDM and charge capture assessment for all Henry Ford Health strategic ventures and initiatives, including opening of new sites, new service offerings and changes in existing services/locations. 

Charge Description Master
1. Manages Charge Description Master file (CDM) update processes for professional and facility, including changes, additions, and deletion requests. Verifies changes and updates are processed properly. Ensures strong internal controls surrounding change control processes are operating as planned and properly maintained. 
2. Develops and maintains CDM policies, ensuring the policies represent current coding, billing, and regulatory requirements. 
3. Coordinates quarterly and annual coding updates (CPT/HCPCS), periodic UB Revenue Code updates, modifier revisions, and regulatory updates related to CDM. 
4. Collaborates with Reimbursement, Compliance, Contracting and other Revenue Cycle Departments to ensure the CDM and related pricing and fee schedules accurately and consistently reflect Henry Ford Health charge structure. 
5. Collaborates with the appropriate HELIOS Application Teams, Revenue Cycle Teams, Subject Matter Experts (SME), Operational and Clinical Leaders to maintain the accuracy EPIC CPT/HCPCS codes, revenue codes, modifiers and other coding considerations based upon multiple payer requirements. 
6. Recommends and coordinates annual professional & facility price updates with Director, System Revenue Integrity and Director, Reimbursement Policy. 
7. Analyzes and determines pricing for all new professional & facility procedures with oversight of Director, Reimbursement Policy. 
8. Leads annual review of charge capture/preference lists for all provider based, non-provider based, and hospital outpatient departments. Coordinates changes with HELIOS and with clinical department leads.

9.  Identifies departments/programs highly impacted by regulatory changes or best practice which may require internal process or system changes regarding charge capture or structure. 
10.Responsible for planning, directing, and evaluating assigned employees as they provide Revenue Integrity/CDM services to Business Units and Henry Ford Health departments. 
11.Assigns, distributes, reviews work assignments ensuring timely and accurate completion. Monitors deadlines. 
12.Responsible for the quality of services provided to Business Units and Henry Ford Health departments. 
13.Responsible for leadership and development of assigned Revenue Integrity/CDM staff, including the identification of internal and external development opportunities to enhance the skills offered to Henry Ford Health customers. 
14.Interviews job applicants for Team vacancies and recommends discipline and termination of assigned personnel as warranted. Prepares mid-year and annual performance appraisals for all assigned staff. 
15.Performs resource planning and scheduling of department personnel to ensure customer requirements are met.