Revenue Cycle Specialist
1 day ago
**Job Summary:**
We are seeking a highly skilled Revenue Cycle & Payor Strategies Specialist to join our team at a growing Private Equity firm focused on healthcare. As a key member of our organization, you will be responsible for handling RCM processes and optimizing payor contract strategies across our portfolio companies.
**Key Responsibilities:**
* Collaborate with the Chief Revenue Officer (CRO) to drive key RCM initiatives, including process enhancements, data analysis, and growth infrastructure improvements.
* Identify and implement RCM process improvements by analyzing large data sets to pinpoint performance issues, establishing standard operating procedures, and developing scalable Power BI dashboards for key performance indicators.
* Support portfolio companies with RCM engagements focused on organizational restructuring, labor management, cost analysis, and the selection of electronic medical record (EMR) systems.
* Prepare portfolio companies for exit by streamlining revenue cycle processes and establishing effective, scalable RCM infrastructures.
* Payor Strategies Center of Excellence (COE):
* Assist the Head of Payor Strategies in conducting strategic reviews of payor contracts and reimbursement strategies.
* Support contract review and negotiation strategies by utilizing SCP data assets to analyze rate structures, competitive rates, quantify rate lift opportunities, and identify referral patterns and growth opportunities.
* Leverage AI tools and technologies to research CMS, state, and payor trends affecting SCP companies. Use these insights to proactively inform companies of billing/reimbursement trends, identify new opportunities, and refine negotiation strategies for optimal rate positioning.
* Contribute to the due diligence process for acquisitions by evaluating payor contract language and reimbursement data, identifying opportunities for synergies and improvements.
* Implement systems and processes to help portfolio companies manage payor contracting targets, renewal pipelines, and contract integration during acquisitions.
**Requirements:**
* Bachelor's degree required.
* 5-8 years of relevant experience in revenue cycle management, managed care contracting, or healthcare consulting, preferably in a private equity, multi-site healthcare, or consulting environment. Familiarity with managed care rates and language is essential.
* Advanced proficiency in Excel, Power BI, and PowerPoint, with strong capability in handling large data sets and creating insightful models.
* Strong analytical skills for data modeling, financial analysis, and rate comparisons for managed care contracts.
* Exceptional communication and presentation skills, capable of conveying complex data and strategic insights to board members and external stakeholders.
* Proven ability to manage multiple projects in a fast-paced environment and influence outcomes across the organization.
**Why Work with Us:**
* Competitive Base Salary
* Competitive Bonus
* Complete Benefits Package
* Accelerated Career Growth
* 401k match
If you are a motivated and experienced professional looking to take your career to the next level, we encourage you to apply for this exciting opportunity.
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