Executive Director, Revenue & Payment Integrity

Make it happen at Hopkins The Johns Hopkins Health System is seeking a seasoned Executive Director of Revenue and Payment Integrity who will lead the organization’s revenue integrity and payment integrity strategy within the Revenue Cycle Management team, ensuring accurate capture, coding, documentation, and billing of services to maximize appropriate reimbursement while minimizing compliance risks. This senior leader oversees clinical and financial review programs, denial prevention and recovery initiatives, coding accuracy, charge capture, and partnership with clinical, HIM, coding, billing, and compliance teams. This leader is also responsible for validating the accuracy of payments by comparing actual payments to expected amounts. Responsibilities include developing and implementing revenue and payment integrity policies and workflows, monitoring key performance indicators (revenue leakage, denials, days in AR, coding accuracy), driving process improvement and system optimization, and managing staff, budgets, and cross-functional relationships. The Executive Director serves as a subject matter expert for regulatory and payer requirements, leads education and audit programs, supports contract and reimbursement analysis, and provides executive reporting to ensure sustainable, compliant revenue performance. Ideal candidates combine deep clinical or coding knowledge, strong analytics and process improvement skills, proven leadership in large health systems or managed care environments, and a track record of reducing revenue leakage and improving financial outcomes. The Johns Hopkins Health System Corporation is a not-for-profit organization dedicated to providing the highest quality of care in the treatment and prevention of human illness. JHHS is an academically based health system consisting of: The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Johns Hopkins Howard County Medical Center, Suburban Hospital, Sibley Memorial Hospital, The Johns Hopkins All Children’s Health System, Johns Hopkins Community Physicians, The Johns Hopkins Medical Services Corporation and Johns Hopkins Medical Management Corporation. The Executive Director of Revenue and Payment Integrity will:

• Lead the organization’s revenue integrity and payment integrity strategy within the Revenue Cycle Management team, ensuring accurate capture, coding, documentation, and billing of services to maximize appropriate reimbursement while minimizing compliance risks.
• Oversee clinical and financial review programs, denial prevention and recovery initiatives, coding accuracy, charge capture, and partnership with clinical, HIM, coding, billing, and compliance teams.
• Develop and implement revenue and payment integrity policies and workflows; monitor key performance indicators (revenue leakage, denials, days in AR, coding accuracy); drive process improvement and system optimization; manage staff, budgets, and cross-functional relationships.
• Serve as a subject matter expert for regulatory and payer requirements, lead education and audit programs, support contract and reimbursement analysis, and provide executive reporting to ensure sustainable, compliant revenue performance.

QUALIFICATIONS:

• Bachelor's degree in healthcare administration, finance, business administration, or a related field (required) and
• Master's degree in healthcare administration, finance, business administration, or a related field (preferred)
• 10+ years of experience in revenue cycle management (required), including 5+ years of management experience with significant business impact (required)
• Depending on individual position assignment, additional certifications may be required
• Navigate rapidly changing situations — from evolving patient needs to technological advancements — by remaining flexible, continuously learning, embracing new challenges, and quickly recovering from setbacks.
• Excellent written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy.
• Applies advanced technical knowledge to solve complex matters within a network function or across multiple business units.
• Makes decisions and recommendations on issues affecting a department or functional area.
• Strong attention to detail and self-directed approach to consistently ensure data integrity and accuracy.
• Upholds ethical principles by maintaining confidentiality, ensuring informed consent, and making decisions that prioritize the well-being of both patients and staff.
• Authority to direct and support employees’ daily work activities; has direct responsibility for hiring, termination, corrective action, and performance reviews.
• Works seamlessly within diverse teams, bringing together professionals from various disciplines to provide patient-centered care and achieve collective goals.
• Identifies control objectives for the designated function and implements cost-effective controls designed to meet those objectives.
• Makes independent decisions related to products, services, implementing new programs, and supporting technical/operational processes of a network or business unit.
• Addresses problems that are highly varied, complex, and often non-recurring, requiring higher-management input and often determining new processes or procedures.
• Applies advanced understanding of discipline/specialization, prior supervisory experience, and advanced interpersonal and communication skills in back-end revenue cycle management.
• Develops and is accountable for the budget of a work department, office, or unit.
• Leads business process improvement for the designated area.
• Performs cost–benefit analyses for the designated area.
• Advanced proficiency and experience using Microsoft Office (Excel, PowerPoint, Word, Outlook).

We’re proud to offer a robust benefits package that supports your health, growth, and well-being. Discover our full offerings and costs here: mybenefitsjhhs.com What Awaits You:

• Competitive pay and benefits that support you at every stage of your life and career.
• Retirement plans with employer contributions to help you plan confidently for the future.
• Generous time off so you can unplug, recharge, and enjoy life outside of work.
• Access to world-class facilities and innovative technology that fuel your curiosity.
• Endless opportunities to advance your career as part of the Johns Hopkins team

Salary Range: Minimum 214,102.00/annually - Maximum 261,178.00/annually Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. The Hospital reserves the right to modify employee schedules as needed. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices. Johns Hopkins Health System and its affiliates are drug-free workplace employers. Apply tot his job Apply To this Job