Revenue Assurance Manager Reporting Analytics

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

 

The Revenue Integrity Manager of Reporting and Analytics plays a crucial role within Optum/NLH by leading and driving key strategic initiatives to support the company’s growth and achievement of strategic objectives. This role will be part of the Revenue Integrity team and will report to the Director of Revenue Assurance. This role will work closely with other teams internal and external to RCM, to develop and execute strategic initiatives related to Revenue Optimization and Revenue Integrity that align with the company’s overall goals.

 

If you are located in Maine, you will have the flexibility to work remotely* as you take on some tough challenges.

 

Primary Responsibilities:

• Analyze Revenue cycle data to identify trends, patterns and areas for improvement
• Develop and deliver data necessary to drive process changes and improvements in the areas of charge capture, payment integrity and denial management
• Report on identified trends and work in collaboration with the Director of Revenue Assurance to develop a remediation plan
• Identify trends and recommend potential audits to the RI Audit Manager
• Train RI Analysts in report generation software and how to interpret and analyze the data and make audit recommendations to improve charge capture and/or net revenue
• Support Revenue Optimization initiative by supplying timely data with detail trend analysis
• Maintain skills in the tools and databases used to develop reports and trend analysis
• Manage billing error, denial data, and charge error reports in conjunction with the existing denial project team
• Contribute and/or lead process improvement initiatives within the enterprise revenue cycle by recognizing process improvement opportunities, anticipating and proposing opportunities, engaging stakeholders, conducting root cause analyses and developing and executing plans to achieve best practice
• Solid understanding of regulatory guidance, governments and commercial payer regulations related to hospital revenue cycle and the ability to interpret them apply toward best practices within the enterprise revenue cycle
• Ability to manage multiple projects and affective prioritization
• Develop and maintain relationships with key stakeholders within the member organizations
• Work collaboratively with multiple departments to evaluate new service line requests prior to implementation
• Develop reporting required to support Revenue Optimization and Revenue Leakage projects
• Perform analyses to understand net revenue effect of proposed changes in conjunction with finance and clinical operations
• Develop processes for deploying policies and procedures for compliant revenue charging activities of clinical departments in conjunction with appropriate stake holders and subject matter experts
• Develop effective relationships among internal/external stakeholders, colleagues and staff to build trust and lead individuals/teams through change initiatives
• All other duties as assigned

 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 7+ years of progressively responsible experience in revenue cycle operations or a relatable field 
• Knowledge of business analysis techniques
• Advanced experience with business applications such as SQL, Snowflake, Excel, Power Point, Visio

 

Preferred Qualifications:

• Detailed knowledge of Revenue Cycle, reimbursement, and regulatory information
• Working knowledge of all functional areas of the revenue cycle, including contract and denial management, CDM and charge capture management, coding, registration, billing, customer service, etc. with specialized subject matter expertise in at least one area
• Working knowledge of Medical Terminology, Current Procedural Coding (CPT, HCPCS), Diagnostic Coding (ICD-9, ICD-10), and HIPAA ANSI codes (remark and adjustment codes)
• Working knowledge with regulations and accreditation standards, knowledge of specific state and federal requirements and standards
• Working knowledge of Medical Record, Financial Services and Healthcare Application technology
• Intermediate Microsoft software knowledge and ability to train/assist end-user
• Demonstrated experience in diagnosing, evaluating and developing corrective actions for problems in operations
• Experience or proven aptitude in the management of multiple projects and priorities
• Ability to interpret an extensive variety of instructions furnished in written, oral, diagram, or schematic form
• Creative and “outside of the box” problem solver is necessary for this position
• Flexible and able to react to ever changing priorities
• Able to effect collaborative alliances and promote teamwork
• Effective organizational, planning, controlling, scheduling and project management abilities

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.