Manager, Revenue Cycle Optimization and Education

Baptist Health

2d•Onsite

About The Position

The Manager, Revenue Cycle Optimization and Education is responsible for overseeing the quality and training functions for Patient Access denial prevention. This individual will design and implement audit programs, identify performance gaps, and develop targeted training solutions. The Manager will create and deliver structured onboarding curricula, annual refresher programs, and focused ad-hoc education that support long-term competency, compliance, and operational accuracy. The Manager will conduct comprehensive research, analysis, and trending of rejections and denials to identify root cause and drive sustainable corrective action. Additionally, the Manager will collaborate closely with Patient Access, Managed Care, Coding, Medical Records, and Revenue Cycle Operations to ensure alignment with payer requirements, regulatory standards, and organizational goals. Through data-driven insights and cross-functional partnership, the Manager will lead performance improvement initiatives that reduce preventable denials, strengthen front-end accuracy, and enhance overall revenue integrity. This position may have additional duties assigned that are within scope of the role.

Requirements

Degree required in Business Administration, Healthcare Administration, Finance, Education or other related fields that support operational, analytical, or instructional responsibilities, Bachelor’s degree preferred.
Minimum 10 years’ experience within healthcare revenue cycle, with at least 7 years dedicated to Patient Access operations across technical workflows such as registration, insurance verification, prior authorization, financial clearance, and front-end denial prevention.
Advanced training or coursework in revenue cycle management, healthcare operations, instructional design, quality improvement, or payer compliance is strongly preferred.
Demonstrated expertise in analyzing, trending, and resolving technical denials, including the ability to identify root causes and implement sustainable corrective actions.
Experience developing and delivering training programs, competency assessments, audit tools, and performance improvement initiatives that support operational accuracy and compliance.
Leadership or management experience strongly preferred, including oversight of teams, coaching, workflow development, and cross-functional project leadership.
Active Certified Healthcare Access Manager (CHAM), or Certified Healthcare Access Associate (CHAA), or Certified Revenue Cycle Specialist (CRCS) required or obtained within 1 year of hire.

Responsibilities

Oversee all front-end technical denials associated with Patient Access workflows, including registration accuracy, eligibility verification, prior authorization, medical necessity validation, and service order completeness.
Partners closely with Patient Access leadership and the Patient Access System Director to implement corrective actions, redesign workflows, and establish clear accountability mechanisms that support denial prevention.
Conducts comprehensive root-cause analysis on technical denials and develops targeted, sustainable action plans to prevent recurrence.
Designs, leads, and maintains the Patient Access Quality Review Program with a strong focus on reducing preventable denials and improving front-end accuracy.
Performs routine and targeted audits of Patient Access functions, identifying compliance issues, accuracy gaps, and training needs that impact revenue integrity.
Develops high-quality reports and dashboards for the Patient Access System Director and revenue cycle leadership, providing actionable insights and performance trends.
Creates and deploys targeted ad-hoc training based on real-time denial trends, audit findings, and operational needs.
Develops and maintains annual refresher training for Patient Access and related departments, ensuring ongoing competency and alignment with organizational standards.
Designs and oversees new-hire onboarding and competency-based training programs focused on denial prevention, workflow accuracy, and regulatory compliance.
Collaborates with system education departments to ensure training content aligns with Baptist Health standards, payer requirements, and regulatory updates.
Supports systemwide denial mitigation strategies in partnership with the Patient Access System Director, contributing to organizational revenue integrity goals.
Leads, coaches, and mentors staff, establishing clear performance expectations and ensuring consistent execution of denial prevention workflows.
Prepare regular denial trend reports, performance summaries, and recommendations for process improvement.
Serves as a system-level subject matter expert in denial prevention, Patient Access accuracy, payer requirements, and training methodology.
Participates in cross-functional committees, revenue cycle task forces, and performance improvement initiatives to advance systemwide operational excellence.