Executive Director, Revenue Integrity

The Executive Director of Revenue Integrity is a strategic enterprise leader responsible for optimizing gross revenue, safeguarding net revenue, and ensuring system-wide accountability across the charging lifecycle in a multi-state healthcare system. This role is grounded in three core pillars of charge assurance, revenue assurance and payer escalation management. This role drives strategic oversight of charge capture, pre-claim reconciliation, claim edits, clinical denials management and payer escalation, while providing governance and subject matter expertise across the charging lifecycle. The Executive Director partners with operational, clinical, and financial stakeholders to ensure compliant, accurate, and optimized revenue outcomes.

Duties and Responsibilities:

Charge Assurance

• Lead enterprise-wide chargemaster strategy, governance, and maintenance. Strong partnership with Enterprise Analytics for strategic pricing optimization.
• Lead enterprise-wide charge capture initiatives to ensure accuracy, completeness, and compliance.
• Oversee pre-claim reconciliation processes to prevent leakage and improve billing readiness.
• Develop and enforce charge governance policies, audit protocols, and escalation pathways.

Revenue Assurance

• Partner with coding, billing, and clinical documentation teams to reduce claim edits and prevent denials.
• Monitor and improve KPIs related to clean claim rates, denial overturns, and reimbursement velocity.
• Implement analytics and reporting tools to proactively identify revenue risks and opportunities

Payer Escalation Management

• Serve as the escalation point for complex payer issues impacting revenue flow.
• Lead resolution strategies for systemic payer challenges, including underpayments, denials, and contract misalignment.
• Collaborate with managed care, legal, and compliance teams to drive payer accountability and performance.

* Mentor and develop a team of revenue integrity professionals, fostering growth, engagement, and retention.

* Set clear performance expectations and hold teams accountable to operational and strategic metrics.

* Promote a culture of transparency, continuous learning, and cross-functional collaboration.

Minimum Education: Bachelor's Degree in Health Administration, Business, Finance or related field; 3 additional years of experience plus the minimum experience requirement may substitute for minimum education.

Minimum Experience: 10+ years of related experience plus 7 years of experience in a leadership capacity

Skills and abilities:

* Strategic and systems-level thinking

* Strong analytical and financial acumen

* Executive presence and influencing skills

* Exceptional communication and collaboration abilities

* Strong ability to lead cross functional teams