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    Director, Medical Claims Operation - New York, NY, United States - Parsley Health

    Parsley Health
    Parsley Health New York, NY, United States

    2 weeks ago

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    Description

    Parsley Health is a digital health company with a mission to transform the health of everyone, everywhere with the world's best possible medicine.

    Today, Parsley Health is the nation's largest health care company helping people suffering from chronic conditions find relief with root cause resolution medicine.

    We are seeking a highly strategic and results-oriented individual to fill the role of Director, Revenue Cycle Operations.

    This position is pivotal in ensuring optimal revenue capture from our payer channels through effective collaboration with cross-functional teams and a deep understanding of healthcare payer contracts, reimbursement strategies, and revenue cycle management.

    As the Director of Revenue Cycle Operations, you will be responsible for developing and executing comprehensive strategic plans aimed at maximizing revenue from payer channels while aligning with the organization's overall financial objectives.

    This role demands versatility, requiring you to navigate both strategic planning and hands-on execution. You will be expected to immerse yourself in operational processes while also synthesizing information to deliver executive-level presentations. This person reports directly to our SVP, Business & Clinical Operations.
    Execute a multigenerational revenue cycle management plan ensuring alignment with Parsley Health's long term strategy.
    Establish key performance indicators (KPIs) and metrics to track payer operations and revenue performance, identifying areas for improvement.
    Analyze payer reimbursement patterns, denials, and claims data to identify trends, areas for improvement, and revenue enhancement opportunities.
    Cultivate and maintain strong relationships with current partnerships to optimize accurate and timely reimbursements through various payer programs.

    Stay abreast of relevant healthcare regulations, billing guidelines, and payer policies to ensure compliance with industry standards and adapt to changes.

    Oversees payer operations team, including staff managing third party billing relationships and claims management, and proactively escalates issues to the Executive team when they arise.

    Manages Payer Ops Team performance by establishing clear goals and expectations and develops team members on their career goals.

    Collaborate with other departments, such as Operations, Finance, Sales, Customer Success and Product teams, to implement strategies that optimize revenue growth and minimize revenue leakage.

    Lead large, cross-functional operations projects by gaining executive alignment, establishing clear timelines and outlining key requirements.
    vendors, contractors) to support payer operations.
    Provide analytical analysis, create written processes, and train others in implementing a cross functional revenue cycle team.

    Develop and implement practice-specific process improvement recommendations to secure positive results, monitor performance and improve resolution plans for unfavorable trends.

    You have a proven experience in ambulatory revenue cycle management, payer relations, and healthcare reimbursement processes
    You have 5-7 years of operational leadership or general management and experience in ambulatory revenue cycle management
    Excellent analytical skills with the ability to interpret data, identify trends, and make data-driven decisions
    Clear communication style and structured, process-thinking approach
    Professionalism with physicians, executive leadership, and external stakeholders
    Ability to convert large strategic ideas into actionable operations
    Remote-first with the option to work from one of our centers in NYC or LA
    ~ Subsidized Medical, Dental, and Vision insurance plan options
    ~ We recognize that the person we hire may be less experienced (or more senior) than this job description as posted. We embrace diversity and are committed to building a team that represents a variety of backgrounds, perspectives, and skills. In light of recent increase in hiring scams, if you're selected to move onto the next phase of our hiring process, a member of our Talent Acquisition team will reach out to you directly from an @parsleyhealth.
    We will never communicate with you via Microsoft Teams
    We will never ask for your bank account information at any point during the recruitment process, nor will we send you a check (electronic or physical) to purchase home office equipment
    LI-Remote
    #
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