Role Overview:
The Senior Manager, Revenue Cycle Enrollment is responsible for the oversight of all functions within Revenue Cycle Enrollment, including but not limited to providing support for the daily department operations, AR oversight and ongoing coordination of enrollment functions including analysis and productivity improvements of their team. Through their team, they will provide timely and accurate processing of provider and facility enrollments with all payers.
The Senior Manager, Revenue Cycle Enrollment lead and facilitate process improvements and further enhance the enrollment process with providers and facilities. This position requires extensive knowledge of enrollment related workflows, processes and regulations.
Principal Duties and Responsibilities:
Leadership Impact & Problem Solving:
- Develop in-depth knowledge of system programs and services and foster strong collaboration with multiple System and Network departments.
- Communicates changes, outcomes, and analysis with RCO leadership and MGB Enterprise leadership on a regular basis.
- Actively contributes to the strategic direction of the Revenue Cycle Enrollment team.
- Collaborates with other RCO departments and MGB Enterprise departments to ensure projects and initiatives are implemented successfully and to provide transparency on enrollment turnaround times, optimizations, etc.
- Conduct performance reviews of direct reports; develop and mentor direct reports and staff.
- Maintain strong communication with Director(s) and business partners in reporting of enrollment activities.
Operational Performance:
- Oversee the Provider Enrollment function for the MGB Enterprise provider network including payer enrollment with governmental payers and commercial payers, delegated enrollment functions and facility enrollment functions.
- Maintains comprehensive knowledge of state and federal enrollment regulations to ensure enrollment functions are completed accurately and timely.
- Manages day-to-day operations of delegation and facility teams, including identification and monitoring of team success metrics and activities related to Enrollment.
- Provide coaching and mentorship with direct reports.
- Oversight of enrollment related AR including claim edits and denials and ensures appropriate analysis and resolution is performed timely and accurately including reporting, analytics and trending for reduction in AR loss related to denials and write offs.
- Identify areas of improvement for standardization of enrollment data and documentation of enrollment related activities.
- Develop and maintain a working knowledge of all core systems (Epic) and ancillary systems (MD Staff, iPort, etc.)
- Develop the division's operational policies, procedures standards and expectations.
- Schedule regular staff meetings for updates, new policies, education, open discussion related to healthcare, diversity, training, encouraging positive work environment
- Research operational and system issues identified by other RCO departments and develop/implement solutions for performance improvement
Financial Performance:
- Validate and reassess productivity standards through observations, documenting and sharing for management review and recommend resolution/feedback
- Review avoidable write-off trends and identify & implement opportunities to reduce avoidable write-offs
- Work with other RCO departments and MGB leadership to improve collections, reduce accounts receivable, reduce denial rates, and reduce avoidable write-offs through issue identification, research, communication, and process improvement
- Other duties as assigned
Qualifications Qualifications: Education
- Bachelor's degree required, Masters preferred
Work Experience
- At least 10 years of related health care business experience, including 5 or more years of experience in management or program management
Skills/Abilities/Competencies:
- Outstanding communication and interpersonal skills and proven ability to develop strong working relationships
- Proven ability to successfully collaborate with and achieve results across multiple RCO and MGB Enterprise departments.
- Ability to work with minimal direction and to exercise good judgment
- Outstanding ability to identify, prioritize and resolve critical issues efficiently and effectively
- Outstanding ability to effectively and confidently present ideas and information to a variety of audiences and all levels of management
- Excellent diplomatic skills and the ability to successfully navigate complex organizational politics
- Ability to participate confidently in executive-level groups
- Proven customer service orientation
- Ability to develop and achieve goals and deadlines
- Proven ability to manage multiple priorities and succeed in a fast paced, rapidly changing environment
Supervisory Responsibilities:
Working Conditions:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job
- This position is currently remote, though the individual may be required, on occasion, to travel into the office or Mass General Brigham sites due to business needs (travel will be reimbursed per MGB policy)
- Hospital work environment working conditions include possible exposure to diseases or infections and may require safety gear (PPE) such as gloves and mask
- Normal office working conditions. The noise level in the work environment is quiet to moderate.
- While performing the duties of this job, the employee is frequently required to sit; talk; or hear; use hands to finger; handle; or feel; reach with hands and arms. The employee is occasionally required to stand; walk; and stoop; kneel; or crouch. The employee must frequently lift and/or move up to 5 pounds and occasionally lift and/or move up to 20 pounds
- Specific vision abilities required by this job include close vision, distance vision and depth perception
About Us:
As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.
We're focused on a people-first culture for our system's patients and our professional family. That's why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees' personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development-and we recognize success at every step.
Our employees use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.
Diversity Statement
As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.
EEO Statement Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
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