System Director Revenue Integrity at Quorum Health · Location…

System Director Revenue Integrity

System Director, Revenue Integrity

Enterprise leadership for charge capture, CDM governance, revenue assurance, compliance, and clinical revenue cycle integration.

Position Details
Remote

You must reside in one of these states to be eligible for this position:

Arkansas California Kentucky
Massachusetts Nevada New Mexico
Oregon Utah Tennessee
Texas Wyoming

Position Summary

The System Director, Revenue Integrity leads the health system's enterprise Revenue Integrity function and sets the strategy, governance, controls, and operational infrastructure needed to ensure complete, accurate, compliant, and timely revenue capture across the organization.

This executive serves as the system's leader for charge capture, chargemaster (CDM) governance, clinical revenue cycle integration, revenue leakage prevention, reimbursement compliance, and Revenue Integrity performance. The Director partners closely with Finance, Revenue Cycle, Clinical Operations, Coding/HIM, Compliance, Information Technology, Supply Chain, Pharmacy, and hospital leadership to ensure that clinical activity is accurately translated into compliant and collectible revenue.

The role provides enterprise oversight across all hospitals, ambulatory locations, professional services, ancillary departments, and other applicable business units. The Director also leads the continued development and maturation of the Revenue Integrity operating model, including organizational structure, policies, governance, technology, analytics, education, auditing, and performance management.

Key Responsibilities

Enterprise Revenue Integrity Strategy and Leadership

• Develop and execute the health system’s enterprise Revenue Integrity strategy, operating model, and multi-year roadmap.
• Establish standardized Revenue Integrity policies, procedures, controls, and governance across hospitals and business units.
• Define clear accountability for charge capture, charge reconciliation, chargemaster maintenance, documentation, coding, and revenue-related operational processes.
• Serve as the executive subject matter expert for Revenue Integrity and advise senior leadership on compliance risk, revenue opportunity, operational performance, and strategic priorities.
• Lead the development and continued maturation of the enterprise Revenue Integrity organizational structure.
• Build and maintain strong working relationships with hospital presidents, CFOs, COOs, clinical executives, Revenue Cycle leadership, Compliance, IT, HIM, Coding, Pharmacy, Supply Chain, and departmental leaders.

Charge Capture and Revenue Assurance

• Provide enterprise oversight of charge capture processes across hospital, professional, ambulatory, procedural, diagnostic, pharmacy, supply, implant, and ancillary services.
• Develop standardized charge reconciliation processes to ensure services rendered are reflected on patient accounts accurately and on time.
• Establish controls to identify missing, duplicate, delayed, inaccurate, or unsupported charges.
• Partner with clinical departments to integrate appropriate charging processes into operational and clinical workflows.
• Develop processes for monitoring late charges, manual charges, charge corrections, charge lag, and other indicators of revenue leakage or process failure.
• Establish departmental ownership and accountability for charge capture performance.

Chargemaster and Fee Schedule Governance

• Provide executive oversight of hospital chargemasters (CDMs), professional fee schedules, charging dictionaries, and related reference files.
• Establish enterprise CDM standards for CPT and HCPCS assignment, revenue codes, modifiers, pricing, charge descriptions, charge logic, and billing configuration.
• Develop formal processes for ongoing CDM maintenance, annual and quarterly code updates, regulatory changes, new services, new technology, and charge requests.
• Ensure consistent charging methodologies across hospitals and service lines where clinically and operationally appropriate.
• Establish governance for requests to add, modify, deactivate, or otherwise change chargeable services.
• Partner with Finance and executive leadership on pricing strategy, gross charge methodologies, and compliance with hospital price transparency requirements.

Revenue Integrity Audit and Revenue Leakage Prevention

• Develop a comprehensive enterprise Revenue Integrity audit and monitoring program.
• Identify and address missing charges, incorrect charges, coding discrepancies, documentation deficiencies, billing errors, payer issues, and reimbursement variances.
• Establish risk-based audit priorities using financial, operational, regulatory, and utilization data.
• Ensure identified issues result in documented corrective action and follow-up monitoring, supported by education, workflow remediation, or system changes as needed.
• Quantify and report financial opportunities, recoveries, prevented revenue leakage, and compliance-related findings.
• Establish repeatable processes for validating that corrective actions remain effective over time.

Regulatory, Coding, and Reimbursement Compliance

• Monitor changes in CMS, state, and other regulatory requirements, AMA coding guidance, and commercial payer policies that affect charging, coding, reimbursement, and billing.
• Ensure regulatory changes are translated into operational, system, and CDM updates throughout the organization.
• Partner with Compliance, Coding, HIM, and Legal as appropriate to interpret and operationalize complex billing and reimbursement requirements.
• Promote compliant charging practices while supporting appropriate and complete reimbursement for services provided.
• Ensure Revenue Integrity activities are appropriately coordinated with Coding, Clinical Documentation Integrity, Billing, Denials, Contracting, and Compliance functions.

Clinical and Operational Revenue Cycle Integration

• Partner with clinical and operational leaders to improve the accuracy and reliability of charge capture at the point of care.
• Develop service-line-specific Revenue Integrity strategies for high-risk or high-value areas such as Surgery, Cardiology, Cath Lab, Interventional Radiology, Emergency Services, Pharmacy, Infusion, Imaging, Laboratory, Rehabilitation, and Oncology, as well as supply and implant charging.
• Establish processes to incorporate Revenue Integrity review into new service development, new technology implementation, departmental workflow redesign, and capital planning.
• Educate clinical and operational leaders on their role in revenue capture and billing compliance.
• Promote an organizational culture in which Revenue Integrity is viewed as a shared operational responsibility rather than solely a back-end Revenue Cycle function.

Technology and EHR Optimization

• Partner with Information Technology and application teams to ensure EHR and revenue cycle systems support accurate, efficient, and compliant charge capture.
• Provide Revenue Integrity leadership for major EHR implementations, conversions, upgrades, and optimization initiatives.
• Oversee business requirements related to charging workflows, charge routers, automated charging, interfaces, preference lists, order-to-charge logic, supply charging, pharmacy charging, professional charge capture, and related revenue cycle functionality.
• Ensure charging logic and CDM configuration are appropriately tested before implementation.
• Establish governance for system configuration changes that affect charging, billing, or reimbursement.
• Promote automation and exception-based workflows where appropriate to reduce manual intervention and improve accuracy.

Analytics and Performance Management

• Develop an enterprise Revenue Integrity performance framework and executive dashboard.
• Establish key performance indicators related to charge capture, charge lag, late charges, reconciliation completion, CDM accuracy, audit findings, financial opportunity, corrective action, and departmental performance.
• Use analytics to identify trends, outliers, risks, and opportunities across hospitals and service lines.
• Establish transparent reporting to senior leadership and operational stakeholders.
• Develop departmental scorecards and accountability mechanisms where appropriate.
• Track financial value generated through Revenue Integrity initiatives, including recovered revenue, prevented leakage, process improvement, and risk mitigation.

Organizational Development and Education

• Recruit, develop, and retain a high-performing Revenue Integrity leadership and technical team.
• Establish clear roles and responsibilities across enterprise and local Revenue Integrity resources.
• Develop career pathways and succession planning within the Revenue Integrity function.
• Establish competency standards for Revenue Integrity staff.
• Develop an enterprise education program for Revenue Integrity employees, clinical departments, operational leaders, and other stakeholders.
• Promote ongoing professional development and relevant certifications.