Revenue Integrity Manager

## Job Summary:
MaineGeneral Health is seeking an experienced and strategic Revenue Integrity Manager to lead departmental operations and oversee initiatives that support accurate reimbursement, revenue optimization, and financial performance across the organization.

This role is responsible for developing and implementing strategies that strengthen revenue integrity, improve financial processes, and ensure compliance with regulatory requirements and payer guidelines. Working collaboratively with clinical, financial, and administrative leaders, the Revenue Integrity Manager provides oversight of charge capture, Charge Description Master (CDM) maintenance, billing and reimbursement analysis, and other revenue optimization initiatives.

The ideal candidate brings strong leadership, financial and analytical expertise, and a comprehensive understanding of healthcare revenue cycle operations. This position offers an opportunity to influence organizational financial performance while driving sustainable improvements that support MaineGeneral Health's long-term goals.

Job Description:

- Lead the daily operations of the Revenue Integrity department, ensuring alignment with departmental goals and broader organizational objectives.
- Partner with leadership to establish departmental goals, performance standards, operational strategies, and long-term improvement initiatives.
- Direct revenue integrity programs and financial optimization strategies designed to improve reimbursement accuracy, maximize revenue, and support organizational financial health.
- Establish performance benchmarks, monitor key performance indicators, and use data analytics to identify trends, opportunities, and areas for improvement.
- Provide direct oversight of charge capture integrity, Charge Description Master (CDM) maintenance, and billing and reimbursement analysis.
- Monitor payment variances, reimbursement trends, and potential revenue risks, developing strategies to address discrepancies and improve financial outcomes.
- Ensure departmental operations and revenue integrity processes comply with applicable regulatory requirements, payer guidelines, contractual agreements, and organizational policies.
- Oversee staff management and development, including recruitment, performance evaluations, scheduling, payroll, employee engagement, and conflict resolution.
- Promote a positive and productive team environment that encourages professional development, accountability, and employee satisfaction.
- Manage departmental budgets, vendor relationships, and resource allocation to ensure operational effectiveness and financial responsibility.
- Evaluate equipment, staffing, and resource needs; develop recommendations and justify capital and operational expenditures as appropriate.
- Collaborate with clinical, financial, and administrative departments to strengthen revenue processes, improve communication, and implement sustainable solutions.
- Lead special projects, organizational initiatives, and strategic programs as assigned by leadership.
- Utilize data analytics, payer requirements, and industry standards to identify opportunities for revenue improvement and strengthen organizational compliance.

Qualifications:

- Experience in healthcare revenue cycle management, revenue integrity, reimbursement, or healthcare financial operations.
- Demonstrated leadership experience, including staff supervision, performance management, and team development.
- Strong understanding of healthcare reimbursement methodologies, payer requirements, billing processes, and regulatory compliance.
- Knowledge of charge capture processes, Charge Description Master (CDM) maintenance, and revenue integrity practices.
- Experience analyzing financial data, payment variances, reimbursement trends, and operational performance metrics.
- Strong financial management skills, including budgeting, resource allocation, and expense oversight.
- Ability to develop and implement operational strategies, performance improvement initiatives, and sustainable process improvements.
- Excellent analytical, problem-solving, and decision-making skills.
- Strong communication and relationship-building skills, with the ability to collaborate effectively across clinical, financial, and administrative teams.
- Ability to manage multiple priorities, lead complex initiatives, and drive results in a dynamic healthcare environment.

The salary range shown reflects the base salary for this position. Individual compensation is determined based on factors such as experience, qualifications, skills, and market considerations. We are proud to offer a competitive total rewards package designed to recognize our caregivers and support them in delivering exceptional care to the communities we serve.

## Scheduled Weekly Hours:
40

## Job Exempt:
Yes

Benefits:

Supporting all aspects of our employees’ wellness – physical, emotional and financial – is a critical component of being a great place to work. With the wide range of benefits and programs available, employees have the resources they need to be well at every stage of life and plan for the future.

Physical Wellness:

- We offer quality health, dental, and vision benefits and wellness programs and resources to provide employees access to resources for a healthy lifestyle and help manage health care costs.
- Employees have access to industry-leading leave for new parents.
- A generous earned time plan is offered to all employees - We believe employees need and deserve time away from work to observe holidays, be with family, go on vacation, or simply take care of themselves.

Emotional Wellness:

When life gets challenging, employees have access to our Employee Assistance Program for employees and anyone in their household.

Financial Wellness:

- Access the wages you’ve already earned before payday with Payactiv, giving you greater flexibility over your finances.
- Tuition Reimbursement is available to all employees to further develop skills and career.
- We offer eligible employees up to 2% of eligible pay in 403(b) company-matching contributions plus another 2% in the 401(a) retirement income plan.
- Three insurance plans are available to protect your family from the sudden loss of income in the event of your death, terminal illness or serious injury from accident.
- We offer both short-term and long-term disability insurance to replace a portion of your income if you become disabled and cannot work for a period of time.

Career Mobility:

Helping our employees develop their skills and grow their careers is critical to how we retain our talent and sustain our business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know that our employees are our most valuable resource – they’re how we grow our business and care for our community.

Equal Opportunity Employer M/F/Vet/Disability  Assistive technologies are available. Application assistance for those requesting reasonable accommodation to the career site is available by contacting HR at (207) 861-3440 .