Position Summary / Career Interest:

This position directs all aspects of the Charge Description Master and supporting team, specifically CDM management and gross charge CDM pricing. Directs the employee workflow and performance. Provides direction and leadership to departmental staff, ensuring a high level of customer service is provided. Interacts closely with Director and supports the overall vision of department and organizational goals. Works in collaboration with multiple departments within the health system. Supports and adheres to The University of Kansas Health System's Code of Ethics and Business Standards.


Responsibilities and Essential Job Functions

• Assists in directing the operational performance and overall management of the Chargemaster (including Charges, Orderables, and Performables) and Pricing functional areas.
• Teams with key departments, including but not limited to, Pre and TOS, Compliance, Coding, HIM, Finance, Revenue Integrity, and Clinical Departments to establish and oversee onboarding process and approval workflows for new procedure requests.
• Oversees the development, maintenance, and strategic management of the CDM to support accurate charging and charge capture and optimal revenue and reimbursement.
• Works closely with IT to develop, test, and implement workflows that drive accurate charge capture and charge routing to support compliant and optimal revenue integrity and CDM build.
• Facilitates review and approval of clinical charge capture tools and methodologies such as but not limited to flowsheets, documentation-based charging (e.g., Proc Doc), explosion/cloning charging, and preference lists/charge navigators.
• Directly responsible for configuration and maintenance of the Epic All Procedure (EAP) Master File and all related configuration elements influencing charge capture including but not limited to cost center assignment and bed charge billing tables.
• Creates and implements an annual CDM review and audit plan to identify discrepancies and charging opportunities and identify and mitigate compliance risks.
• Assist with the development of institutional policy related to the Health System’s Charge Description Master.
• Works in collaboration with the Department of Finance and Reimbursement and other financial stakeholders to implement and routinely update policy for Setting of Self Pay Discount.
• Plays a key leadership role in developing CDM analysts to assist with management of all aspects of the Health System’s Charge Description Master.
• Collaborates closely with hospital audit and compliance on activities related to the preparation and response CDM or charge-related items found to be non-compliant.
• Establish and cultivate relationships with clinical and administrative stakeholders to proactively communicate changes to pricing and CDM.
• Oversee annual gross charge price setting, vendor outputs, and validate pricing is in line with guiding principles and payer contracts.in partnership with hospital reimbursement, audit and compliance, and other financial stakeholders and pricing consultants.
• Assists in the development of fee schedule(s) to align with payor contracts and market rates.
• Stays current on changes in healthcare regulations, payor policy changes, and coding guidelines that have a direct or indirect impact to the CDM and charge capture.
• Works with senior leadership to ensure all CDM-related activities adhere to federal, state, and local regulations.
• Supports internal and external audit requests related to the CDM and charge capture.
• Facilitate activities to ensure the institution receives appropriate reimbursement from payors, while helping to ensure compliance with applicable billing regulations.
• Assists in preparing department budget and monitors cost centers within respective downline.
• Ensures accurate and timely processing of assigned functions by establishing and maintaining quality and productivity measures are in place, reviewed and acted on appropriately.
• Work closely and collaboratively with Revenue Cycle Leadership Team, Clinical Leadership Team and Finance Teams to optimize outcomes.
• Establishes, maintains and monitors performance of outside vendors supporting assigned responsibilities.
• Provides leadership, motivation and inspiration to downline managers and staff within the department.
• Focuses on departments internal and external stakeholders and support the team’s ability to deliver a high level of customer service and meet customer expectations.
• Provides feedback and works directly with clinical staff and departments to identify trends and to develop and implement action plans for improving revenue cycle workflows.
• Establishes and monitors reports to provide overall status of assigned functions and identify trends. Shares reports and results as appropriate.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• Bachelors Degree in Business Administration, Business Management or related field of study from an accredited college or university.
• 6 or more years of experience in healthcare revenue cycle operations
• 5 or more years of leadership experience
• Designated Epic training must be completed within 6 months of hire into position

Preferred Education and Experience

• Master's Degree in Business Administration, Business Management or a related field of study from an accredited college or university.
• 7 or more years of experience in healthcare revenue cycle operations
• 6 or more years of leadership experience

Knowledge Requirements

• Demonstrated knowledge of Hospital Charging procedures.
• Demonstrated knowledge of Medicare coding rules and regulations.
• Demonstrated knowledge and history of compliance with payor audits.
• Demonstrated leadership and team management skills
• Solid operational management and process/technology optimization skills
• Excellent personnel management and organizational management skills – including written and oral communication, relationship management, customer service, and organization
• Comprehensive knowledge of patient registration contractual terms and requirements, health insurance practices, and industry standards
• Ability to create and manage respectful and impactful relationships with internal and external stakeholders
• Experience and passion towards mentoring and developing team members
• Proficient in Excel, Word, PowerPoint.
• Ability to travel between Health System locations with minimal to no notice.

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.