Senior Manager for the Revenue Cycle and Financial Services

MassachusettsGeneral Hospital is an Equal Opportunity Employer. By embracing diverseskills perspectives and ideas we choose to lead. Applicationsfromprotected veterans and individuals with disabilities are stronglyencouraged.

Reporting to the Associate Director of Financial Services the Senior Financial Services Administrative Manager (FSAM) manages the daily operations of Registration Services Financial Counseling and the Financial Access Unit. The FSAM assures program compliance with state federal and payer regulations in order to generate revenue from various state federal and private insurance programs. The FSAM plans coordinates and implements program strategies policies and procedures across MGH hospital departments and the Partners enterprise by working closely with Hospital senior management clinicians and all staff levels to assure operational effectiveness and efficiency. Responsible for approximately $2 billion in overall revenue the FSAM works across the Financial Services spectrum to ensure that financial processes maximize reimbursement.

Prioritizes the Admitting and Registration Departments daily activities and implements solutions to meet deadlines goals and objectives; and to capture nearly $2 billion in revenue annually. Addresses emerging payer requirements and trends. Monitors and supervises work of the Financial Services supervisors to ensure that Admitting policies procedures and standards for performance are maintained and administered in an equitable and consistent manner. Ensures quality and productivity standards for all divisions.

Collaborates in appeals process communication implements operational efforts and collaborates with a variety of hospital departments. Manages responses and interventional approaches to payer and contract management issues. Works collaboratively with Partners Payer Operations to identify and address payer issues with contract managers.

Sets and monitors appeals process goals and objectives for increasing revenue capture.

Analyzes and interprets monthly Inpatient/SDC Denial Status Overview report package for senior leadership and numerous related reports in order to affect approximately $50 million in annual revenue. (e.g. Patient Accounts Managers Writeoff High dollar Weekly Appeals Status & Ad Hoc Denial reports). Analyzes and manages response for denial trends and monitors outlier appeals in collaboration with Partners payer operations unit in order to improve revenue cycle operations both internally and externally.

Analyzes interprets and coordinates data for all aspects of Financial Services namely authorization and denial metrics financial assistance outcomes patient discharge planning with long term care MassHealth denials and appeals Administrative Free Care clinical approval payer trends and department efficiency and quality benchmarks. Ensures quality and quantity standards are met and surpassed. Analyzes report statistics and narratives relative to measure performance and ensure meeting metrics.

Identifies projects to improve services. Continually seeks way to widen service scope to reduce hospital bad debt and to increase hospital revenues.

Mentors supervisors team leaders and other staff. Guides supervisory staff in the resolution of employee problems. Leads hiring decisions and ensure department diversity. In conjunction with supervisors interviews hires orients trains and provides input for evaluation and/or corrective action for subordinate staff.

Assists in preparing operating and capital budgets and monitors budget performance. Identifies and recommends methods for limiting expense maximizing revenue and deploying personnel.

Plays a key role in the design of Epic operations and helps define new processes as required. Develops collaborative relationships and acts as a liaison to hospital payers and other Partners entities regarding all Financial Service responsibilities.

Strives to improve all services provided by the Financial Services Department and continually improves the customer service provided to patients and their families administrative and clinical personnel various State agencies and the MGH referral network.

Attends and participates in meetings and committees as appropriate. May initiate meetings or develop committees as deemed necessary.

Works with Outpatient Practices Department of Nursing Case Management Central Business Office Community Benefits Practice Support Unit Patient Advocacy Office of General Counsel and Medical staff to provide coordination of quality patient services for hospital reimbursement and discharge planning.

Attends monthly meetings including financial rounds to increase oncology and transplant center compliance and improved performance within each functional area. Attends various internal meetings with payers Partners Central Business Office social work nursing case management community benefits and with external groups like MHA and Division of Medicaid.

Supports the Director of Admitting and Registration and the Associate Directors in all special projects and other duties as assigned.

Acts as a primary back up to other department managers and works collaboratively to help them meet daily responsibilities and department goals. Responds to hospital emergencies including and not limited to system down times and all other disaster scenarios.

Serves as Huron usability expert and coordinates process for onsite system resource support and software usability improvement.

Proven ability to manage and lead large groups

Analyze interpret and communicate data in written and verbal form

Lead team in process improvement initiatives

Strong written and verbal communication skills