Revenue Integrity Manager - San Mateo Medical Center (Open & Promotional)

Job Description:

Revenue Integrity Manager - San Mateo Medical Center (Open & Promotional)

Description

Description

Note: This recruitment schedule was amended on December 4, 2025 to extend the Final Filing Date. This recruitment has been changed to "Continuous."


At San Mateo County Health, we lead by example. From our most seasoned professionals to our newest team members, everyone has the opportunity to step forward to offer their insight, opinions and ideas. As part of our hospital, you'll have the chance to explore new avenues for growth while you meet the diverse healthcare needs of a thriving, vibrant community. If you're ready to discover the leader in you, we invite you to discover San Mateo County Health. San Mateo County Health is located is 25 minutes South of San Francisco, 25 minutes North of San Jose and 25 minutes from beautiful Half Moon Bay!

As a Revenue Integrity Manager - San Mateo Medical Center (Financial Services Manager II), you are responsible for the development, coordination, implementation, and oversight of the revenue integrity function. The basis of revenue integrity at San Mateo Medical Center (SMMC) is to prevent recurrence of issues that can cause revenue leakage and/or compliance risks through effective, efficient, replicable processes and internal controls across the continuum of patient care.

The ideal candidate for this position will have:

• Broad understanding of the healthcare revenue cycle, demonstrated by process improvement initiatives that led to quantitative improvements in revenue cycle performance and key performance indicators.
• Broad understanding of Medicare and Medicaid (Medi-Cal) regulations and programs demonstrated with a history of working in organizations with revenue sources from Medicare and Medi-Cal.
• Strong analytical thinking, attention to detail, effective communication, and problem-solving abilities.
• Bachelor's degree in Business, Finance or Healthcare Administration, Master's degree preferred.
• Seven (7) years of progressive experience in medical billing or revenue cycle operations, including five or more in a leadership role at a hospital or healthcare environment.
• Advanced leadership, coaching, and team development skills.
• Strong written and oral communication and collaboration skills with the ability to partner across functions and departments.
• Proficiency in EHR systems (e.g., EPIC)
• HFMA Certified Revenue Cycle Representative.

Responsibilities include:

• Manage the Charge Description Master to ensure inclusion of all billable service codes. Support and facilitate the annual charge description master (CDM) pricing review in alignment with finance and reimbursement policies and guidelines.
• Maintain, review, and revise internal policies, and procedures related to revenue integrity. Communicate and ensure training for such policies and procedures to stakeholders.
• Ensure the effectiveness of the revenue integrity program, including overall consistency and integration of integrity activities throughout the organization.
• Work closely with the CFO and Compliance Officer to ensure that the revenue integrity program meets applicable financial, operational, and legal requirements. Monitor and assess integrity risks and ensure that the revenue integrity program is responsive to those risks.
• Develop key performance indicators for revenue integrity and define targets based on industry standards. Track metrics and report on no less than a monthly basis to the CFO, Revenue Cycle Excellence Committee, and Executive Management Team. Identify barriers to meeting targets and lead related performance improvement activities.
• Perform ongoing monitoring of charge capture patterns, including late charges, charge reconciliation, coding conflicts and charge related denials, to identify and prioritize areas for optimization.
• Partner with clinical departments to support timely and accurate charge capture. Drive communication of CDM changes to impacted clinical departments
• Support clinical departments related to new revenue initiatives, serve as the subject matter expert in the development of new CDMs to support the new clinical service offering.
• Oversee monitoring of bulletins from the Centers for Medicare & Medicaid Services, Medi-Cal and other payors. Assess the impact of such bulletins and coordinate with revenue cycle managers to implement changes driven by such informational bulletins; ensure the action plans are implemented accurately and in a timely manner.
• Consult with the Compliance Officer as needed and serve as liaison to revenue cycle, supporting auditing, data and analytics requests.
• Facilitate revenue cycle participation in compliance audits and investigations, plan and execute internal compliance reviews, audits and activities, and conduct routine internal audits of department revenue capture.
• Serve as an internal resource for billing-related questions, provide training related to charge capture, and work with various departments to help ensure billing compliance.
• Collaborate with other department managers on relevant aspects of assigned program area; discuss organization problems, develop alternatives strategies for dealing with those problems; assist in implementation of solutions, as necessary.
• Direct, mentor and evaluate staff. Ensure staff members are knowledgeable about revenue assurance needs and reimbursement issues identified through audits, reviews, and aggregate data analysis.
• Oversee the management of EPIC work queues, identify automation opportunities, and partner with Health Information Technology to address updates or changes needed to optimize revenue cycle performance.
• Perform related duties as assigned.

Qualifications
Education and Experience:
Any combination of education and experience that would likely provide the required knowledge, skills and abilities is qualifying. A typical way to qualify is:

• Three years of increasingly responsible experience performing a wide variety of administrative, financial, managerial or automation duties in a large, complex public agency.

Knowledge of:

• Federal, State and local laws and regulations applicable to assigned area of responsibility, such as public liability and/or accounting laws.
• Advanced principles and practices of fiscal resource planning.
• Advanced principles of financial administration, including public budgeting and reporting.
• -Advanced principles of financial and actuarial forecasting and financial analysis.
• Basic principles and practices of County-wide operations and its administration and organization.
• Principles of personnel training, supervision and evaluation.
• Computer systems and applications as used within the County.

Skill/Ability to:

• Plan, organize, supervise, coordinate, direct, organize and participate in a wide variety of advanced administrative and operational activities related to the assigned work section, program area specialty or department.
• Coordinate activities with other departments, programs and/or outside agencies.
• Direct and participate in the analysis of a wide variety of highly complex administrative and operational problems and make effective operational and/or procedural recommendations.
• Develop, administer and interpret policies, guidelines and procedures related to the assigned program area.
• Plan, schedule and manage large scale projects.
• Negotiate agreement between differing individuals and groups of individuals.
• Monitor current and proposed Federal, State and local legislation which impact on assigned area of responsibility.
• Utilize appropriate interpersonal style and methods of communication to gain acceptance, cooperation, or agreement of a plan, activity, and/or program idea.
• Work cooperatively with other County departments and public and private organizations.
• Supervise, evaluate and train assigned personnel.
• Communicate effectively both orally and in writing.
• Perform complex mathematical and statistical calculations accurately.
• Prepare complex and detailed written reports, procedures, grant applications and contracts.
• Establish and maintain effective work relationships with those contacted in the performance of required duties.

Application/Examination

Open & Promotional. Anyone may apply. Current County of San Mateo and County of San Mateo Superior Court of California employees with at least six months (1040 hours) of continuous service in a classified regular, probationary, extra-help/limited term positions prior to the final filing date will receive five points added to their final passing score on this examination.
The examination process will consist of an application screening (weight: pass/fail) based on the candidates' application and responses to the supplemental questions. Candidates who pass the application screening will be invited to a panel interview (weight: 100%). Depending on the number of applicants, an application appraisal of education and experience may be used in place of other examinations, or a screening committee may select those applicants whose education and/or experience appear to best meet the needs of the position based solely on the information provided in the application documents. Because of this screening process, all applicants who meet the minimum qualifications are not guaranteed advancement to the next phase of the examination process. All interviews will take place in San Mateo County, California and applicants must participate at their own expense.

IMPORTANT: Applications for this position will only be accepted online. If you are currently on the County's website, you may click the "Apply" button. If you are not on the County's website, please go to https://jobs.smcgov.org/ to apply. Responses to the Supplemental Questionnaire must be submitted in addition to the standard County employment application form. A resume will not be accepted as a substitute for the required application materials. Online applications must be received by the Human Resources Department before midnight on the final filing date.

This is a continuous recruitment which may close at any time. The final filing date will be posted 5 days in advance in the County of San Mateo Human Resources Department.

Apply immediately. This recruitment is open on a continuous basis and selections may be made at any time within the process.

TENTATIVE RECRUITMENT SCHEDULE
Final Filing Date: Thursday, December 4, 2025, at 11:59 P.M. PST
Screening: December 8-10, 2025
Combined Panel Interviews: Week of December 15, 2025

About the County
San Mateo County is centrally located between San Francisco, San Jose, and the East Bay. With over 750,000 residents, San Mateo is one of the largest and most diverse counties in California and serves a multitude of culturally, ethnically, and linguistically diverse communities.

The County of San Mateo, as an employer, is committed to advancing equity to ensure that all employees are welcomed in a safe and inclusive environment. The County seeks to hire, support, and retain employees who reflect our diverse community. We encourage applicants with diverse backgrounds and lived experiences to apply. Eighty percent of employees surveyed stated that they would recommend the County as a great place to work.


The County of San Mateo is an equal opportunity employer. We seek to hire, support, and retain employees who reflect our diverse community.



Analyst: Debbie Kong (11202025) (Financial Services Manager II-D151)

Salary:

$154,876.80 - $193,585.60 Annually