The Chargemaster Manager develops prices for the hospital in accordance with hospital/department policy and regulatory requirements. Provides the hospital with ongoing maintenance of the chargemaster. Communicates changes in the chargemaster to users throughout Patient Financial Services and client departments hospital-wide.

Principal Duties and Responsibilities

The statements below describe the essential duties of the person or persons assigned to this job. They are not intended as an exhaustive list of all job duties and responsibilities.

1)       Develops and maintains strategic pricing model to produce various pricing scenarios using core variables (current price, market, cost, fee schedules, and payor mix).

2)       Develops and documents pricing strategy recommendations and coordinates annual strategic pricing review.  Assesses the charge structure using peer comparison, internal cost and claims level data.  

3)       Presents pricing strategy recommendations to senior management for review and approval.  Provides supporting documentation for recommendations including analysis of changing regulation and payment methodologies, utilization, technology and market trends.

4)       Creates ad hoc and standard pricing reports summarizing benchmarking, cost, and revenue data. Utilizes reports to test pricing scenarios, actual charges, access charge structures, analyze trends, and review CPT/HCPCS codes

5)       Works directly with the Managed Care Finance team to ensure pricing strategies reflect accurate payor assumptions and comply with contractual requirements. Provides a link between Budget, Cost Reporting, and Cost Accounting (Decision Support).

6)       Analyzes the chargemaster’s accuracy in accordance with regulatory requirements, compliance requirements, and appropriateness of bundling/unbundling of charges.  

7)       Conducts on-site interviews with Clinical Departments for line-item review to confirm procedure methodologies.  Reviews CPT/HCPCS codes, descriptions, revenue codes, missing chargeable items, incorrect items, and deactivations to ensure their accuracy.

8)       Ensures that the CPT/HCPCS codes and revenue code updates are completed in accordance with department and hospital policy.

9)       Communicates chargemaster changes to Clinical Departments, Patient Financial Services, Medical Records, Revenue Management, and Compliance. Ensures that changes to the chargemaster are thoroughly communicated and documented. Provides clinical departments with revised procedures including changes, effective dates and examples as needed to ensure a thorough understanding of the rules chamge.

Minimum Knowledge and Skills required by the Job

1.       Work requires the knowledge of theories, principles, and concepts typically acquired through completion of a Bachelor's degree in Business Administration, Finance or Health Care Management or a closely related field and five to six years experience.

2.    Work requires the analytical skills necessary to plan for, design or enhance highly‑complex hospital‑wide systems and programs, resolve problems requiring a comprehensive and state‑of‑the‑art awareness of the technology and literature in a professional, technical or scientific field, or develop financial and operating plans for a large department/division.

3.       Work requires the ability to persuade and negotiate with peer level managers on issues and programs that impact assigned unit/department. Work requires effectively dealing with conflicting views or issues and mediating fair and workable solutions

4.       A working-knowledge of CPT-4 and revenue coding is required.