Program Manager (Oncology Revenue Optimization)
About The Position
The Program Manager will lead the strategic development and implementation of key initiatives supporting Oncology Care Coordination. This role provides program-level oversight of processes related to the review and auditing of documentation, charges, claims, and denials across services such as Principal Illness Navigation, Chronic Care Management, Health Assessments, Social Determinants of Health, and Advance Care Planning. The successful candidate will design standardized workflows, establish performance metrics, and drive system-wide tracking and reporting to ensure accurate and comprehensive revenue capture. This highly collaborative role partners across clinical, operational, IT, and revenue cycle teams to optimize documentation, billing, and program effectiveness while aligning with organizational priorities.
Requirements
- Bachelor’s Degree in Business, Healthcare Administration, or a related field
- Minimum of five (5) years of experience in the healthcare industry
- At least three (3) years of experience in professional billing
- Strong knowledge of coding systems including CPT-4, HCPCS, and ICD-10
- Demonstrated ability to lead cross-functional initiatives and drive process improvements
Nice To Haves
- AAPC and/or CPC certification preferred
Responsibilities
- Lead the strategic development, implementation, and continuous improvement of documentation, billing, and audit processes
- Analyze denials and reimbursement trends to identify payor patterns and optimization opportunities
- Design and implement standardized workflows to ensure consistent and accurate revenue capture
- Establish and monitor key performance metrics to drive program success and improvements
- Identify gaps in documentation, billing processes, or EMR functionality and lead enhancements
- Develop tools, training materials, and resources to improve documentation quality and billing accuracy
- Build strong cross-functional relationships to advance Oncology Care Coordination initiatives
- Represent revenue optimization efforts in system-wide committees and planning forums
- Lead project management efforts, ensuring timelines, milestones, and deliverables are achieved
- Oversee implementation of new processes and evaluate outcomes against strategic goals
Benefits
- Comprehensive Benefits
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Number of Employees
1,001-5,000 employees
