MGR OUT OF NETWORK OPERATIONS [Arbitration/ Revenue Cycle]

Envision Healthcare•Issaquah, WA

About The Position

The Manager of Out of Network Revenue Operations Strategy is responsible for leading analytical initiatives that drive operational performance and strategic decision-making related to out-of-network reimbursement disputes. This role manages a team of analysts and collaborates cross-functionally to identify process improvements and support arbitration workflows.

Requirements

Strong analytical and strategic thinking skills.
Excellent communication and presentation abilities.
Ability to manage multiple priorities in a fast-paced environment.
Experience working with large datasets and healthcare claims data.
Demonstrated ability to lead and develop junior team members.
Familiarity with healthcare revenue cycle preferred to have experience with federal or state arbitration under the NSA
Experience with SDLC
Bachelors degree required.
5 years relevant work experience required, with 2 years of consultation experience preferred.
Healthcare experience with a focus in RCM and/or accounts receivable in large multi-state integrated healthcare settings required.
Healthcare experience is preferred.
Strong mastery of Excel and experience with SQL or other tool to query large datasets

Nice To Haves

Familiarity with data warehouses and data modeling / visualization tools like Qlik / Power BI / Tableau, are a plus

Responsibilities

Manages employees by supporting, coaching, training, assisting with time management and performing evaluations; should conduct regular meetings with all direct reports.
Serves as a subject matter expert on out-of-network reimbursement trends, data analytics, and arbitration performance.
Oversees and performs advanced data analysis using tools such as SQL, Tableau, and Power BI to identify payment trends, performance gaps, and process improvement opportunities.
Designs and develops automated reports, dashboards, and data visualizations that translate complex data into actionable business insights.
Partners with business intelligence, payor analytics, and operational teams to define metrics, design analytical frameworks, and optimize arbitration strategies.
Develops and maintains standard operating procedures (SOPs), process documentation, and training materials related to analytical and operational workflows.
Leads the creation and continuous improvement of data models, automation tools, and performance tracking mechanisms to support KPIs and measure business outcomes.
Supports strategic initiatives by providing analytical insights and operational recommendations to senior leadership.