Job Overview
Location
MO-REMOTE
Job Type
Full-time
Category
Software Engineering
Date Posted
June 6, 2026
Full Job Description
đź“‹ Description
- • Serves as a subject matter expert in regulatory analysis, payer policy interpretation, and compliance-driven revenue cycle initiatives at SSM Health.
- • Monitors and interprets complex regulatory changes from CMS, Medicare Administrative Contractors (MACs), Medicaid, and commercial payers to ensure organizational compliance.
- • Translates federal, state, and commercial payer regulations into actionable operational workflows and billing practices across the revenue cycle.
- • Leads large-scale, cross-functional projects related to revenue cycle and compliance, from initiation through implementation, coordinating with coding, billing, clinical operations, compliance, and finance teams.
- • Develops detailed project plans, timelines, and deliverables to ensure timely execution of regulatory initiatives and mitigation of audit risk.
- • Supports audit response efforts by conducting documentation reviews, developing appeal strategies, and designing corrective action plans.
- • Provides advanced guidance, training, and education to revenue cycle teams and operational leaders on regulatory updates and compliance expectations.
- • Creates and distributes training materials, communications, and resources to align frontline operations with current regulatory requirements.
- • Acts as the primary liaison between regulatory guidance and operational execution, ensuring alignment between policy changes and daily revenue cycle activities.
- • Functions in a leadership capacity through influence and expertise, driving strategic initiatives without direct managerial authority.
- • Maintains organizational compliance to prevent revenue loss and reduce exposure to regulatory penalties.
- • Performs other duties as assigned to support the mission of SSM Health’s Regulatory Research department.
🎯 Requirements
- • Bachelor’s degree
- • Five years’ experience in revenue cycle, regulatory compliance, or related field
- • Demonstrated experience interpreting CMS, MAC, Medicaid, and commercial payer regulations
- • Strong analytical ability and proven track record in translating regulatory guidance into operational workflows
- • Preferred: CHC Certification or demonstrated compliance experience
🏖️ Benefits
- • Paid Parental Leave: One week of paid leave for newborns or newly adopted children (pro-rated based on FTE)
- • Flexible Payment Options: Access to earned, unpaid base pay before payday through DailyPay (fees may apply)
- • Upfront Tuition Coverage: Eligible team members receive upfront tuition coverage through FlexPath Funded
Skills & Technologies
About SSM Health Care Corporation
SSM Health Care Corporation operates a Catholic, nonprofit integrated health system serving Illinois, Missouri, Oklahoma, and Wisconsin. It encompasses 23 hospitals, numerous physician practices, outpatient facilities, and a health plan. Services include primary, specialty, acute, post-acute, and home care, along with research and education programs. Governed by a board of directors and sponsored by the Franciscan Sisters of Mary, the organization emphasizes holistic, community-focused care rooted in Catholic social teaching.
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