Revenue Cycle Optimization Manager (Program Manager 1-B-LDH)

Program Manager 1-B Ldh (Revenue Cycle Optimization Manager)

At JPHSA, we are committed to providing quality behavioral health, developmental disabilities, and primary care services and supports. Make a difference in the community and join our team today.

The Finance Operations Division provides accounting and revenue cycle management services to JPHSA and its programs. The Program Manager 1-B LDH (Revenue Cycle Optimization Manager) is accountable for the oversight and management of all revenue cycle workflows and processes and ensures compliance with federal and state laws as well as payor-specific regulations and requirements (Centers for Medicare & Medicaid Services, Louisiana Medicaid, private / military Managed Care Organizations, etc.). This position supervises the three Administrative Program Specialist -A positions who work in Revenues Cycle Management (RCM). The position reports to the Finance Operations Division Director (Chief Financial Officer) with functional oversight by the Executive Director.

Minimum Qualifications :

Seven years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR

Six years of full-time work experience in any field plus four years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR

A bachelor's degree plus four years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR

An advanced degree or a Juris Doctorate plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services.

Experience Substitution :

Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.

Job Duties and Other Information :

As a Revenue Cycle Optimization Manager, you will :

• Serves as the point person for the third-party revenue cycle vendor, third-party electronic health record, and third-party coding vendor
• Develops, in consultation with the Chief Financial Officer (CFO) and Executive Director, and with input from the Service Area Division Directors, key performance indicators, i.e., metrics for revenue cycle management. Tracks metrics and reports on no less than a monthly basis to the CFO, other members of the Executive Management Team, and the Executive Director. Provides analysis as requested. Proposes corrective action and / or performance improvement activities to the CFO
• Manages the Charge Designation Master (Charge Master) to ensure inclusion of all billable service codes in accordance with the Charge Designation Master procedure. Performs ongoing monitoring by service code and updates as needed to ensure avoidance of over- and underpayment. Manages updating the Charge Master as needed with no less frequency than annually (based on Calendar Year). Maintains documentation that supports changes made to the Charge Master per procedure
• Develops, in consultation with the CFO and Administrative Program Manager 2, following internal policy and procedure development guidelines, policies, and procedures related to revenue cycle management. Communicates and ensures training for such policies and procedures to direct reports and the Division Directors
• Manages relations with providers, payors, and contractors as follows.
• Oversees monitoring of bulletins by Revenue Cycle Management staff from the Centers for Medicare & Medicaid Services and other payors. Assesses the impact of such bulletins on revenue cycle management operations; develops action plans to implement changes driven by such informational bulletins; ensures the action plans are implemented accurately and timely manner. Consults with the Compliance Officer as appropriate
• Monitors the geographic service area for entry of new payors; participates in contract negotiation from time to time, as needed. Provides assistance to the General Counsel as requested

Position-Specific Details :

Appointment Type : Probational, Promotional, or Job Appointment

Career Progression : This position does not participates in a Career Progression Group.

Work Schedule : Work hours are 8 : 00 AM to 4 : 30 PM, Monday - Friday.

Compensation : The salary offered will be determined based on qualifications and experience.

Louisiana is a State As a Model Employer (SAME) that supports the recruitment, hiring, and retention of individuals with disabilities.