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Program Manager, Revenue Compliance

Requisition ID:

21154944

Business Unit:

Hartford HealthCare Corp.

Location:

Hartford, CT

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Description

Job Schedule: Full Time
Standard Hours: 40
Job Shift: Shift 1
Shift Details: 40 Hours per week

Work where every moment matters.

Every day, almost 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here.  We invite you to become part of Connecticut’s most comprehensive healthcare network.

The story of Hartford HealthCare is the story of transformation – from a handful of disconnected organizations a decade ago to a unified system with a shared, value-based culture of accountability and innovation.  The healthcare landscape has become highly competitive, with new players and disruptive technology and we are working to expand and create our system’s organizational, leadership, cultural, and talent capabilities to ensure Hartford HealthCare will always be the first choice of the people we serve

The Program Manager of Revenue Compliance contributes to the success of Office of Compliance and Integrity through managing system-wide revenue compliance initiatives, activities and projects, including drafting and managing the annual system-wide revenue compliance auditing and monitoring plan.  Develops and oversees implementation of annual revenue compliance plans, training, auditing and monitoring programs, policies and procedures. Responsibilities include but, are not limited to the following:

  • Manages System-wide revenue compliance initiatives, projects and audits per the OCI Work and Audit Plan, developing strong working relationships with system management, employees and key stakeholders.  Performs chart to bill audits in various areas and specialties to evaluate processes and controls in place to provide for accurate charge capture and billing procedures. 
  • Leverages data to perform ongoing monitoring and risk assessment activities.  Recommends strategies designed to proactively manage and mitigate risk.
  • Investigates, as appropriate and necessary, allegations of inappropriate billing activities and manages all HHC revenue compliance investigations, reporting on investigative results.  Has access to all documents, staff, meetings and other information that is relevant to revenue compliance and audit activities.
  • Responsible for the integrity of the compliance incident reporting system and investigation database and all related data and content as it relates to revenue compliance activities.
  • Develop, implement, promote and maintain revenue compliance and audit policies and procedures relevant to the System. 
  • Develop and deliver revenue compliance training, orientation, and education programs for all HHC employees, volunteers, and affiliated providers.
  • Teach, coach and mentor Revenue Compliance Auditors and Senior Revenue Compliance Auditors through the review and validation of any work performed by those team members.  Provide constructive feedback when necessary and collaborate to improve overall team performance.
  • Participates in committees and work groups addressing revenue compliance or audit related subject matter. 
  • Maintain current knowledge of applicable federal and state laws and other regulations and accreditation standards, and monitor advances in revenue compliance and audit standards and changes in regulations to ensure organizational adaptation and compliance. Participate in outside healthcare compliance organizations to stay abreast of developments and best practices within the industry. 
  • Review fraud alerts, regulatory advisories, and enforcement actions issued by regulatory oversight agencies.  Perform risk assessments and provide education and guidance based on these publications.

Qualifications

Education:

  • Bachelor’s Degree required. Master’s Degree strongly preferred.


Experience: 

  • A minimum of six years of health care compliance experience, preferably in a large Healthcare system setting or in a consulting capacity.

Licensure, Certification, Registration

  • CHC, CCEP

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

 
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