Senior Revenue Cycle Management Project Manager – Systems, Reporting, SLA Experience

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

📋 Description

• Manage intricate, multi-dimensional revenue cycle programs from beginning to end.

• Utilize formal project management methodologies (Agile, Waterfall, Hybrid) to oversee scope, timelines, budgets, and risks throughout complex front-, middle-, and back-end revenue cycle initiatives.

• Lead cross-functional teams, which include clinical personnel, billing experts, IT specialists, and executive stakeholders.

• Create detailed project charters, work breakdown structures, and communication strategies.

• Track project milestones and deliverables, ensuring they align with the organization’s strategic objectives.

• Manage and report on Service Level Agreements (SLAs), ensuring adherence to contractual commitments and performance metrics.

• Identify operational bottlenecks and inefficiencies within the revenue cycle continuum.

• Design and implement standardized workflows to enhance efficiency and minimize errors.

• Introduce automation solutions to streamline repetitive tasks and boost accuracy.

• Conduct process mapping and gap analysis to uncover improvement areas.

• Advocate for change management initiatives to ensure the successful adoption of new processes.

• Analyze claim rejection and denial trends to identify underlying causes and systemic challenges.

• Direct focused strategies to enhance clean claim rates and expedite reimbursement cycles.

• Collaborate with coding and billing teams to rectify documentation deficiencies.

• Implement denial prevention initiatives and appeal processes.

• Monitor payer-specific requirements and modify workflows as necessary.

• Track and report on essential Key Performance Indicators (KPIs) such as: Days in Accounts Receivable (A/R), net collection rates, clean claim rates, denial rates, appeal success rates, point-of-service collections, and cost-to-collect ratios.

• Generate regular executive reports and dashboards for senior leadership.

• Develop extensive reporting frameworks to facilitate data-driven decision-making.

• Conduct variance analysis and suggest corrective actions.

• Present findings and recommendations to C-suite executives and board members.

• Serve as a strategic liaison among clinical, financial, and IT departments.

• Facilitate regular meetings with stakeholders to ensure alignment on revenue objectives.

• Simplify complex financial and technical concepts for varied audiences.

• Build consensus amidst competing priorities and resource limitations.

• Maintain open communication channels with all project participants.

• Ensure all billing and coding practices comply with federal, state, and payer regulations.

• Stay updated on regulatory changes, including CMS guidelines, HIPAA requirements, and payer policies.

• Oversee both internal and external auditing processes to ensure compliance and accuracy.

• Coordinate with compliance officers to address audit findings and implement corrective action plans.

• Develop and maintain compliance documentation and standard operating procedures.

• Apply certification knowledge in coding, billing, and auditing to uphold best practices.

• Demonstrate proficiency with Careview and InnovAlone platforms.

• Optimize Electronic Health Record (EHR) system configurations to support revenue cycle workflows.

• Collaborate with IT teams on system implementations, upgrades, and integrations.

• Exhibit strong technical aptitude to quickly learn and adapt to new technologies and platforms.

• Evaluate and recommend revenue cycle management software and tools.

• Ensure data integrity across various systems and platforms.

⛳️ Requirements

• Bachelor’s degree in healthcare administration, business, finance, health information management, or a related field is required.

• A minimum of 10+ years of significant hands-on management experience in healthcare revenue cycle management with a proven track record of leading large-scale projects or transformations.

• Established history of managing enterprise-level revenue cycle initiatives from inception to implementation.

• Experience with Careview and InnovAlone systems is mandatory.

• Demonstrated proficiency in reporting and managing Service Level Agreements (SLAs).

• Experience working within remote or distributed team environments.

• Background in healthcare operations, finance, or health information management.

• Certified Revenue Cycle Professional (CRCP), Certified Revenue Cycle Representative (CRCR), or similar revenue cycle certification is required.

• Certification in coding (CPC, CCS, or equivalent), billing, and/or auditing is essential.

• Advanced proficiency with Careview and InnovAlone platforms is required.

• Exceptional system experience with the ability to swiftly master new technologies and software applications.

• Proficiency in major Electronic Health Record (EHR) systems such as Epic, Cerner, Meditech, or Allscripts.

• Advanced skills in data analytics tools including Tableau, Power BI, Microsoft Excel, or SQL.

• Strong understanding of medical coding (ICD-10, CPT, HCPCS) and billing regulations.

• Familiarity with claims processing systems and clearinghouses.

• Expertise in developing and managing reporting frameworks and dashboards.

• Proven ability to manage and monitor Service Level Agreements (SLAs).

• Change management expertise with a demonstrated ability to drive the adoption of new processes and technologies.

• Attention to detail and accuracy, particularly in financial and compliance matters.

🏝️ Benefits

• Access to a comprehensive and competitive benefits package.

• Retirement planning assistance.

• Opportunities for personal growth through spiritual or academic avenues.

• Time off to recharge and celebrate life's meaningful moments.