Manager – Out of Network Operations Analysis, Arbitration, Revenue Cycle

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversees employee management by providing support, coaching, training, assistance with time management, and conducting evaluations; regular meetings with all direct reports are essential.

• Acts as a subject matter expert on out-of-network reimbursement trends, data analytics, and arbitration performance.

• Manages and executes advanced data analysis using tools such as SQL, Tableau, and Power BI to uncover payment trends, identify performance gaps, and highlight opportunities for process improvements.

• Creates and develops automated reports, dashboards, and data visualizations that convert complex data into actionable business insights.

• Collaborates with business intelligence, payor analytics, and operational teams to establish metrics, design analytical frameworks, and enhance arbitration strategies.

• Formulates and maintains standard operating procedures (SOPs), process documentation, and training materials related to analytical and operational workflows.

• Guides the development and ongoing enhancement of data models, automation tools, and performance measurement mechanisms to support KPIs and assess business outcomes.

• Aids strategic initiatives by delivering analytical insights and operational recommendations to senior leadership.

⛳️ Requirements

• Strong analytical and strategic thinking capabilities.

• Exceptional communication and presentation skills.

• Ability to juggle multiple priorities in a dynamic environment.

• Experience with large datasets and healthcare claims data.

• Proven ability to lead and nurture junior team members.

• Familiarity with healthcare revenue cycle preferred, including experience with federal or state arbitration under the NSA.

• Experience with the Software Development Life Cycle (SDLC).

• Bachelor's degree is required.

• Minimum of 5 years of relevant work experience required, with 2 years of consultation experience preferred.

• Healthcare experience focusing on Revenue Cycle Management (RCM) and/or accounts receivable in large multi-state integrated healthcare settings is essential.

• Healthcare experience is preferred.

• Proficient in Excel and experienced with SQL or other tools for querying large datasets.

• Familiarity with data warehouses and data modeling/visualization tools such as Qlik, Power BI, or Tableau is an advantage.

🏝️ Benefits

• At Envision, we provide benefits that keep pace with your life.

• Our comprehensive range of health and welfare benefits allows you to select the right options for you and your family.

• Best of all, qualifying employees can enroll from day one, ensuring you and your loved ones are well-protected.

• Envision offers a variety of health and welfare benefit choices to safeguard your health and enhance your wellbeing.

• The benefits provided include, but are not limited to: Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking, and HSAs.

• Envision offers paid time off, 9 observed holidays, and paid family leave.

• You earn Paid Time Off (PTO) each pay period, and depending on your position, you can accumulate a minimum of 20 days and up to 25 days per calendar year.