The Opportunity
Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.
Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.
Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.
Join our team as the expert you are now and create your future.
Position Summary
Huron Managed Services is currently seeking a Manager over Vendor Management and Denial Prevention to join Adventist Health’s Centralized Services & Strategy team. The Manager will be a key player in significant Vendor Management initiatives including but not limited to management of vendor relationships, maintenance of vendor reporting, coordination on- and oversight of- vendor performance, implementation of vendor onboarding, analysis of vendor invoices, and RFP/RFI execution. Operational leaders will rely on this individual to manage a team dedicated to supporting the performance of the vendors providing services and solutions within the scope of Huron Managed Services’ revenue cycle functions across Adventist Health.
The Manager will also oversee the execution of system-wide denial prevention strategy including but not limited to identifying denial trends and root causes, reporting on denial and write-off operational metrics, setting and monitoring progress towards metric goals, and collaborating with operational leaders to drive shared accountability toward denial reduction efforts.
Adventist Health partners with BlueLyte solutions for vendor reporting and performance management initiatives, and this individual will be responsible for coordinating closely with BlueLyte and holding them accountable to the expectations of their role. This role will require close coordination with stakeholders from revenue cycle departments that the vendors are providing services and solutions to (i.e. Payer Integration, Care Integration, Consumer Financial Experience), as well as IT, to ensure that all operational and technical matters related to enabling vendor success are addressed in a timely and effective manner.
From a Denial Prevention perspective, the manager will focus on providing Revenue Cycle, Financial, and Clinical Leaders with the necessary tools to address denial and write-off root causes to drive financial and operational improvement. The manager will oversee a team responsible for project management of denial prevention solutions, measurement of denial prevention improvement, and denial task force meeting facilitation.
Qualifications
QUALIFICATIONS
ESSENTIAL DUTIES, TASKS, AND RESPONSIBILITIES
Team Responsibilities
- Oversee and manage a team whose responsibilities include:
- Facilitates ad hoc and recurring calls with revenue cycle services and/or solutions vendors, including those led by a third-party vendor management firm working on behalf of Adventist Health.
- Coordinates with patient financial services and other departments (patient access/pre-services, HIM/coding, etc.) on maintenance or optimization of vendor operating guidelines and workflows.
- Assists with management of vendor relationships on behalf of Adventist Health and in coordination with key vendor contacts. Coordinates with IT on maintenance or optimization of technical workflows and triaging of ad hoc technical issues.
- Completes quality audits for vendors where work set is applicable to the use of third-party quality reviews.
- Develops, optimizes and distributes performance reports for vendors not managed by a third-party vendor management firm.
- Reports on risks, barriers, accomplishments and progress to vendor management leadership and other departments on both a recurring and ad hoc basis.
- Facilitates or assists with the onboarding of new vendors, including coordination on workflow development and establishment of the IT infrastructure.
- Interprets denial and write-off data, identifying trends and opportunity areas for further root cause research
- Coordinates with operational leaders to develop action plans to reduce denials and write-offs
- Develops and manages denial prevention Issues Logs, as well as prioritization of denial solutions within a functional area
- Supports execution of denial prevention solutions by providing operational leaders with necessary data and project management tools
Technical Requirements/Proficiencies
- Strong understanding of revenue cycle reporting processes and analytics
- Ability to translate revenue cycle operational requirements into Cerner system settings and processes
- Understands regulatory compliance requirements for Revenue Cycle technical solutions and reporting
- Expert in Revenue Cycle reporting and is knowledgeable in both patient access (e.g. POS collections, financially secure rates, pre-registration days from service, etc.) and patient accounting metrics (e.g. agings, unbilled accounts, cash reporting, etc.)
- Extensive knowledge of EHR data
- Proficient in analytics and visualization tools including Cerner CCL, SQL, Alteryx, R, Tableau, and/or Power BI
- Proficient in Microsoft Office programs including Outlook, Excel, and PowerPoint
ESSENTIAL DUTIES, TASKS, AND RESPONSIBILITIES
- Revenue cycle workflow and analytics tools utilized at Adventist Health in partnership with Adventist Health technical teams. Responsibilities include supporting application/tool updates, implementations at new Adventist Health facilities, and reporting updates due to system enhancements and process changes.
- Serve as subject matter experts on Cerner Revenue Cycle solutions for the Adventist Health Centralized Services and Strategy Team
- Consult operations stakeholders on comprehensive workflows for Revenue Cycle processes, including current state and future state, to determine how technical solutions will be designed and tested
- Facilitate setting appropriate ticket prioritization and escalate high impact/priority changes as needed
- Review existing Cerner Revenue Cycle solutions to ensure they are appropriately implemented and governed and are compliant with existing regulatory guidelines
- Support Cerner testing activities for enhancements and/or upgrades of technical Revenue Cycle solutions
- Support development of training content for solution enhancements/upgrades
- Support resolution of technical inquiries and issues; provide recommendations to resolve technical issues impacting Revenue Cycle workflows
- Responsible for monitoring data integration feeds into revenue cycle workflow and analytics tools and escalating to appropriate parties when data feeds are missing or incomplete
- Responsible for system alignment between Adventist Health’s internal reporting team and third-party systems reporting
- Responsible for compiling weekly and monthly report sets and distributing to operational leaders for all patient accounting, cash collection, and denial metrics
- Responsible for ad hoc reporting requests from operational revenue cycle leaders, communicating concise results to enable decision making
- Identify improvement opportunities in revenue cycle workflow and reporting, initiates and executes changes in coordination with impacted stakeholders
- Integrate revenue cycle reporting and metrics into planning activities to help the organization optimize results
- Facilitate system access requests for AH managed applications
Education
• Bachelor’s degree, preferably in business administration or a related health care field
• Current Permanent U.S. work Authorization Required
• Required Certifications/Licensure
Required Experience
• At least five years of revenue cycle experience, ideally with focus in patient accounting and other back-end processes
• At least three years of reporting/analytics experience utilizing revenue cycle solutions
• At least three years of supervisory experience
• At least three years of working with revenue cycle vendors (i.e. insurance billing & collections, early out, bad debt, third-party liability, worker’s compensation, Medicaid eligibility, etc.)
Preferred Experience
• Three years of experience with Cerner Millennium, including Registration, Patient Financial Clearance, HIM/Coding, and Patient Accounting
• At least one year of leadership experience in a multi-facility, integrated health care delivery system or consulting experience
The estimated salary range for this job is $80,000 - $130,000. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes and required travel. This job is also eligible to participate in Huron’s annual incentive compensation program, which reflects Huron’s pay for performance philosophy and Huron’s benefit plans which include medical, dental and vision coverage and other wellness programs. The salary range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.
Posting Category
Healthcare
Opportunity Type
Regular
Country
United States of America
