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Manager, Revenue Perform. and Ops. Manager in The Bronx, New York at Rising Ground, Inc.

NewSalary: $80000 - $85000Job Function: Executive/Management
Rising Ground, Inc.
The Bronx, New York, 10455, United States
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Job Description

The role of the Manager of Revenue Performance and Operations is to maximize the productivity of the revenue generating staff in our Medicaid fee for service programs. Importantly, this role will work with internal Rising Ground programs as well as external partners to increase the census, enrollment and billable claims in each of our revenue generating programs. This also includes analyzing caseload size, setting productivity benchmarks, developing growth goals, monitoring internal and external referrals, and supporting the billing team in maximizing claims.

Key Responsibilities

  • Develop internal and external out reach and program marketing plans that will drive enrollment into the Medicaid Fee for Service Programs.
    • Ensure that leadership across the programs of Rising Ground is prioritizing referrals to Medicaid fee for service programs, track internal referrals from each program.
    • Work closely with the Intake and Referral Team to ensure that external promotion of the Medicaid fee for Service programs is taking place and track external referrals.
  • Develop productivity benchmarks and tracking tools relevant to each of the Medicaid fee for service programs ensuring that billable encounters are maximized for each staff member that is delivering services.
    • Work with leadership, oversight and/or external consultants where applicable to devise a plan for each program to ensure maximum utilization
    • Track productivity weekly in each program and provide the leadership with a weekly snapshot of actual vs expected claims.
  • Implement plans of corrective action for teams that are underperforming and monitor compliance with each plan.
  • Create and oversee a centralized scheduling system which ensures that clinical needs are met across the Medicaid programs, minimizing gaps in scheduling.
  • Work closely with the finance and billing team to ensure that the programs are maximizing claims, monitor trends in denied claims and develop plans to correct denied claims.
  • Supervise two staff who will prioritize internal referrals from other Rising Ground programs to the Medicaid fee for service programs, assist the referring programs in the admissions process including gathering documentation to determine eligibility for services and assisting with the consent process when appropriate.
  • Develops a high level of understanding of all of the Medicaid fee for service programs including requirements for billable services and the functions of each of the electronic health records that are used.
  • Supports the Health Services leadership team to ensure that services are being delivered at the highest level while conforming with all oversight requirements.
  • Participates in programmatic budget discussions to ensure that the programs are on track to meet/exceed budgeted revenue.
  • Partners closely with internal supportive divisions; such as Finance, HR, Legal, and Program Development to optimize daily operations and advance division goals.
  • Meets the expectations of a Manager at Rising Ground.
  • Other related duties as assigned by supervisor.

Required Qualifications

  • Bachelor’s degree referred – or – 7+ years of experience monitoring productivity and compliance.
  • Bilingual (English/Spanish) is a plus
  • Comprehensive knowledge of healthcare systems.

Job Location

The Bronx, New York, 10455, United States

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