Senior Manager, Enterprise Denial Prevention & Analytics (PRIZM)

Mayo Clinic•Rochester, MN

18h

About The Position

The Senior Manager provides direction to professional and supervisory staff in the Revenue Cycle. Assures the integrity of revenue and billing information for Mayo Clinic to be appropriately reimbursed for all billable services provided. Participates in providing input in strategic planning with the Revenue Cycle Leadership team. Translates the Mayo Clinic and departmental vision into meaningful and effective responses and results. Establishes key performance indicators with scope of responsibility to effectively manage staff and outcomes. Delegates responsibility and authority to carry out work. Manages multiple functions and serves as a resource with oversight in day to day activities. May manage multi-site operations. Must be able to operate scope of responsibility through complexity and ambiguity. May possess technical knowledge appropriate to functions being managed with additional knowledge in other functions including professional management. Participates in the identification of opportunities to improve processes and to act as a catalyst for realizing these improvements. Acts as a facilitator and generator of new ideas and a mediator on difficult issues. Responsible for recruitment, development and performance management within areas of responsibility, translating the departmental vision into meaningful and effective results. Brings awareness of current external environment issues. Participates in the overall management of the Revenue Cycle by chairing and serving on Enterprise projects/groups, task forces, councils and committees. Serves as a liaison between sections and other departments and agencies inside and outside Mayo. Creates customer service driven sections and fosters collaboration with physician and administrative colleagues. Builds teamwork within the Enterprise Revenue Cycle. Participates in retention planning initiatives. Travel required as assignments warrant. The Senior Manager – Enterprise Denial Management- PRIZM is a key strategic leadership role within our Revenue Cycle organization. This position is responsible for overseeing and advancing enterprise-level prevention and resolution efforts across a large, multi-site academic health system. The successful candidate will be responsible for leading a high-performing team of Senior Business Analysts and Denial Prevention Associates, while also managing and optimizing the use of the PRIZM denial management engine and analytics platform. The role involves cross-functional leadership, interfacing with stakeholders across clinical, operational, and administrative teams to proactively identify denial trends, drive root cause analysis, and execute system-wide strategies to reduce denial volume and improve reimbursement accuracy. Key Responsibilities: Provide strategic and operational oversight for enterprise denial management activities and prevention initiatives. Lead, mentor, and develop a team of Senior Business Analysts and Denial Prevention Associates. Manage and optimize use of the PRIZM engine and associated analytics dashboards, ensuring effective modeling, governance, and insight generation. Collaborate across clinical and non-clinical departments to lead denial prevention workgroups focused on process redesign and revenue integrity. Establish, monitor, and report on key performance indicators (KPIs) to assess and improve denial management outcomes. Engage with physician and administrative leadership to identify system-level gaps and drive improvement initiatives. Participate in strategic planning efforts, serving as a thought leader and advisor to Revenue Cycle leadership. Represent the health system in external industry forums (e.g., HFMA, EPIC academic working groups) to stay ahead of evolving denial trends and share best practices. Facilitate complex problem-solving efforts involving payor trends, documentation workflows, clinical collaboration, and contract interpretation. Translate enterprise strategy into measurable, effective actions within the Denial Management program. During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.

Requirements

Bachelor’s degree in Business, Healthcare, Finance, or a related field and 10 years of relevant experience, including at least 5 years in a leadership role OR 14 years of relevant experience (in lieu of degree), including 5 years leading people, projects, or programs.
Demonstrated experience managing teams, projects, and complex systems in healthcare or consulting environments.
Proven analytical expertise with ability to identify trends, synthesize data, and present insights to senior leadership.
Strong executive presence and communication skills with ability to engage diverse stakeholder groups.
EPIC experience in a revenue cycle context.
Prior experience with denial management and denial analytics platforms.

Nice To Haves

Master’s degree in Business Administration, Health Administration, or related field.
Experience within an academic medical center or large integrated health system.
Active participation in professional organizations such as HFMA or NAHAM.
Background in consulting with success at managing large scale healthcare revenue cycle improvement initiatives, healthcare analytics and denials management.

Responsibilities

Provide strategic and operational oversight for enterprise denial management activities and prevention initiatives.
Lead, mentor, and develop a team of Senior Business Analysts and Denial Prevention Associates.
Manage and optimize use of the PRIZM engine and associated analytics dashboards, ensuring effective modeling, governance, and insight generation.
Collaborate across clinical and non-clinical departments to lead denial prevention workgroups focused on process redesign and revenue integrity.
Establish, monitor, and report on key performance indicators (KPIs) to assess and improve denial management outcomes.
Engage with physician and administrative leadership to identify system-level gaps and drive improvement initiatives.
Participate in strategic planning efforts, serving as a thought leader and advisor to Revenue Cycle leadership.
Represent the health system in external industry forums (e.g., HFMA, EPIC academic working groups) to stay ahead of evolving denial trends and share best practices.
Facilitate complex problem-solving efforts involving payor trends, documentation workflows, clinical collaboration, and contract interpretation.
Translate enterprise strategy into measurable, effective actions within the Denial Management program.