Reimbursement Analytics Manager

JOB SUMMARY:

Manager of Reimbursement Analytics is responsible for leading the company's analysis of commercial and governmental payer reimbursement function. The Manager will use data and reporting from our Revenue Cycle Management systems to make recommendation on ways to maximize the cash collection performance of the company's AR portfolio. Additional responsibilities include collaboration with various other reporting and forecasting teams within the company including, but not limited to, Finance, Commercial, Managed Care and IT.

JOB RESPONSIBILITIES

ESSENTIAL FUNCTIONS:

• Directly manage one or more reimbursement analysts as well as define appropriate functional and developmental goals for the team.
• Facilitate and mentor direct reports in the development of their technical and analytical skills as well as the most effective ways to scope problems and communicate them to stakeholders.
• Analyze accounts receivable and cash collection trends and identify opportunities for improvement across the organization; develop and present business cases for project prioritization.
• Set targets for improved cash collections and report on actual performance against these targets; continue to monitor performance for process control.
• Direct reimbursement improvement projects, collaborating, as appropriate, across the organization (Finance, Commercial, Managed Care and IT).
• Stay current with developing payor coverage and administrative policy changes that could have an impact on payor cash collections; develop appropriate responses and plans to mitigate these risks.
• Perform all job responsibilities in alignment with the industry's best security practices and regulatory guidelines to protect the confidentiality, integrity, and availability of protected health information and other sensitive company data.
• Must be familiar with and abide by the Corporate Compliance Program and all Corporate policies, including the Privacy and Security policies.

NON-ESSENTIAL FUNCTIONS:

• Work with other departments within PathGroup and subsidiaries.
• Nothing in the job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.

EDUCATION & LICENSURE:

• Bachelor's degree in business is required.
• MBA is preferred.

EXPERIENCE/REQUIERMENTS:

• Anatomic pathology or diagnostic laboratory is preferred.
• Minimum 3 years' experience managing teammates, encouraging self-starting, investigative behaviors.
• Minimum 4 years' experience in healthcare in a reimbursement environment.
• Significant hands-on use of Data Warehouses, Analysis Services, PowerBI, and Excel PowerPivot
• Expert knowledge of healthcare revenue cycle and patient billing practices, regulations and processes is required.
• Excellent analytical and project management skills.
• Demonstrated leadership and interpersonal skills. The role will require interaction with a wide range of fellow employees, senior leaders, as well as external auditors and experts.
• Maintain a high standard of discipline and professionalism.
• Ability to think creatively and initiate new ideas or solutions to business issues.
• Independence of thought and sound judgment relating to business needs.
• Ability to work in a fast paced, competing deadline driven environment.
• Proficient with Microsoft Office Suite, specifically Excel, Word, Outlook.