Under the direction and supervision of the Director of Professional Revenue Integrity & Analytics, or his/her designee, the Manager will be responsible for the development, management and maintenance of contract management applications, such as Experian Contract Management. The Manager will constantly seek new ways to leverage the contract management system and will look to capitalize on all features and functionality available. This individual will supervise a team responsible for identifying commercial, governmental and third-party payment variances. Further, he/she will be responsible for establishing efficient work flow processes, setting the department strategy, staff development and the overall management of projects and requests that are assigned to the department. This individual will also serve as a resource for managed care contracting as it relates to contract modeling, contract performance, trend analysis and payer performance.
Posting Position Title: Manager 3
University Job Title: Professional Revenue Analytics Manager
Work Week: Standard (M-F equal number of hours per day)
Required Skill/ability 1: Knowledge and understanding of technology to support healthcare operations, including, but not limited to, database design, logic and optimization to meet business needs.
Required Skill/ability 2: Considerable knowledge of medical office operations, professional fee billing and third party reimbursement methodologies. Demonstrated ability with managed care companies is essential.
Required Skill/ability 3: Solid working knowledge of Microsoft Excel, Word, PowerPoint and Access.
Required Skill/ability 4: Working knowledge of medical coding, regulatory bodies and billing compliance (i.e. HIPAA, NCQA); demonstrated ability with ANSI standard for EDI transaction sets.
Required Skill/ability 5: Ability to communicate information effectively, both oral and written and work effectively as a team member.
Preferred Education, Experience and Skills: (AAPC) CPC certification.
Required Licenses Or Certifications:
Bachelor's Degree in related field and 5 years of experience or an equivalent combination of education and related experience.
Yale University is an American private Ivy League research university located in New Haven, Connecticut. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States.