Manager, Revenue Cycle Systems Architect

Community Care Cooperative•Boston, MA

7d•$102,561 - $125,638•Hybrid

About The Position

The Senior Consultant serves as a strategic leader responsible for managing a team of consultants delivering specialized expertise in patient registration, clinical workflows, and revenue and denial management under the Billing and Credentialing Shared Service. This role holds accountability for the consultant team working on the redesign of operational workflows to improve the financial performance of FQHCs. The Senior Consultant oversees end-to-end optimization of billing, registration, and clinical workflows, as the subject matter expert on revenue cycle strategy. This includes architecting technical designs and overseeing their successful execution. This position is best suited for a revenue cycle expert with knowledge of Epic workflows across multiple disciplines. Collaboration with customer-facing teams across Revenue Integrity, Clinical Operations, Finance and IT is essential.

Requirements

Epic expertise in registration, clinical, billing, data extracts, GL and reporting
Strong knowledge of Massachusetts billing regulations, payer requirements, and FQHC/ACO reimbursement frameworks
Demonstrated leadership and ability to guide complex system builds, optimizations, and Community Connect implementations
Excellent communication skills, analytical thinking, and cross-functional collaboration abilities
Ability to manage multiple projects simultaneously in a fast-paced, evolving environment
High attention to detail and a strong commitment to quality assurance and customer service
Proficiency with Microsoft Office Suite
Strong commitment to C3’s mission

Nice To Haves

Multiple Epic revenue cycle certifications (Charge Router, PB/Resolute, EpicCare Ambulatory or related Epic modules)
Familiarity with the MassHealth ACO program
Experience working in Federally Qualified Health Centers (FQHCs)

Responsibilities

Directly manage team of multi-disciplined consultant analysts across multiple areas in Epic including registration, clinical and billing
Provides direction and support to consultant team to ensure departmental effectiveness and efficiency
Interview, hire, orient and train new consultants
Set clear expectations for consultants at each phase of the engagement, including defining deliverables, timelines, and quality standards
Appropriately match team member skills and strengths to project responsibilities and workstreams
Conducting regular one-on-ones and team check-ins to discuss deliverable status, shared issues, end-user concerns, and upcoming milestones
Identifying and supporting staff development needs, providing guidance on lessons learned and key success factors
Evaluate performance of staff, documenting areas for growth, improvement and areas where staff are excelling
Plan, assign, and direct work of consultants for engagement with customers
Design of consulting framework including engagement initiation, discovery process and pre-engagement scoping
Creation of Statement of work for engagement, including full scope of work, clearly defined deliverables, timeline and costs
Design of documentation templates to report out recommendations and status updates to customers
Create and maintain sustainable processes in Epic for revenue enhancement
Conduct audits of consultant team recommendations on workflows and implement corrective actions to eliminate issues
Act as the primary Epic subject-matter expert for revenue, clinical and reporting application
Build and refine Epic work queues, charge router rules, claims edits, handler tasks and other configuration
Lead testing strategies to validate system build and ensure accuracy
Partner with IT and Epic support (CTC) to identify issues and develop enhancements
Consult with individual FQHCs to identify processes and technology improvements to improve the effectiveness and efficiency of revenue cycle operations
Manage the development of dashboards and reporting tools to track key revenue integrity metrics
Provide detailed analysis and insights to leadership, recommending improvements to optimize revenue cycle performance
Monitor denial patterns and lead cross-functional corrective action plans in collaboration with billing team
Support FQHC expansion, and new revenue cycle initiatives
Develop training programs focused on documentation standards, Epic workflows, coding accuracy, and payer compliance
Collaborate with Billing, Finance, Clinical, Compliance, and IT teams to ensure consistent and compliant revenue cycle practices
Collaborate with internal and external constituents to execute improvements
Serve as a trusted advisor across departments, leveraging in-depth system knowledge to enhance operational efficiency
Contribute to shaping the vision for C3 as the preferred resource for an affordable and efficient MSO in Billing and Credentialing
Perform other duties as assigned