Manager, Revenue Cycle State & Federal Programs in Oceanport, New Jersey at RWJBarnabas Health

Job Title: Manager

Location: System Business Office

Department Name: Patient Accounts

Req #: 0000246936

Status: Salaried

Shift: Day

Pay Range: $70,000.00 - $100,000.00 per year

Pay Transparency:

The above reflects the anticipated annual salary range for this position if hired to work in New Jersey.

The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.

Job Overview:

The Manager, Revenue Cycle, State & Federal Programs is responsible for the strategic oversight, operational performance, and continuous improvement of Medicaid, Charity Care, and other financial assistance program resolution activities. This position provides leadership and direction for staff responsible for eligibility determination support, application resolution, quality assurance, agency relations, and patient financial assistance operations. The Manager serves as the primary liaison between hospital leadership, county welfare agencies, state agencies, managed care organizations, and community partners to ensure timely and accurate eligibility determinations and maximize program conversion and approval rates. The position is responsible for developing operational standards, monitoring key performance indicators, implementing process improvements, ensuring regulatory compliance, and providing leadership to support organizational financial assistance goals. The Manager collaborates with Patient Access, Revenue Cycle, Case Management, Social Work, Financial Counseling, Information Technology, and other operational departments to improve patient access to available assistance programs while enhancing operational efficiency, regulatory compliance, and patient satisfaction.

Qualifications:

Required:

• Minimum of five (5) years of experience in Medicaid Eligibility, Financial Counseling, Charity Care, State and Federal Programs, Revenue Cycle, or related healthcare operations.
• Demonstrated experience managing Medicaid and Charity Care resolution processes with proven success in maximizing conversion and approval rates.
• Experience developing and maintaining productive relationships with county assistance offices, state agencies, managed care organizations, and community partners.
• Strong knowledge of Medicaid eligibility requirements, Charity Care regulations, and healthcare financial assistance programs.

Scheduling Requirements:

• Full-Time, Salaried position– 37.5 hours a week
• Oceanport, NJ - Hybrid Schedule (2 days remote, 3 days on-site per week)
  • Training fully on-site

Essential Functions:

• Manage daily operations and workflow related to Medicaid, Charity Care, and financial assistance resolution activities.
• Oversee staff responsible for eligibility resolution, application processing, patient outreach, follow-up activities, and agency communication.
• Recruit, hire, train, develop, and lead a team of supervisors, analysts, and account representatives.
• Provide regular coaching, mentoring, feedback, and annual performance evaluations.
• Establish productivity, quality, and customer service expectations and ensure accountability to departmental standards.
• Monitor approval rates, denial trends, conversion rates, application aging, unresolved accounts, and other key operational metrics.
• Ensure timely completion, submission, follow-up, and resolution of Medicaid and Charity Care applications.
• Ensure staff obtain required documentation and conduct patient outreach within established timeframes to support successful eligibility determinations.
• Develop and maintain collaborative relationships with County Welfare Agencies, State Medicaid Agencies, Managed Care Organizations, and community partners.
• Serve as the primary escalation point for complex eligibility cases, agency issues, and operational barriers.
• Analyze trends, variances, approval rates, denial patterns, and operational performance to identify improvement opportunities.
• Develop and implement action plans designed to improve conversion rates, reduce denials, and enhance patient outcomes.
• Oversee quality assurance initiatives to ensure compliance, consistency, and accuracy in application processing and eligibility resolution activities.
• Develop and implement training programs to ensure staff remain current on regulatory requirements, policy changes, and operational procedures.
• Prepare for and support internal and external audits.
• Monitor and ensure compliance with applicable federal, state, payer, and organizational requirements.
• Recommend and lead implementation of workflow enhancements, system improvements, and operational best practices.
• Partner with Information Technology and operational stakeholders to improve system functionality, reporting capabilities, and data integrity.
• Collaborate with Patient Access, Revenue Cycle, Case Management, Social Work, Financial Counseling, and other operational departments to improve financial assistance outcomes.
• Represent the department in leadership meetings, system initiatives, and strategic planning activities.
• Monitor quality control measures and audit processes to identify risks, improve performance, and safeguard operational integrity.
• Build and maintain effective relationships with patients, staff, agency representatives, and organizational stakeholders.
• Establish clear expectations, assign responsibilities, monitor progress, and ensure achievement of departmental goals.
• Foster a collaborative work environment that promotes employee engagement, accountability, and professional development.
• Communicate organizational and departmental decisions consistently to team members.
• Perform other duties as assigned.
• Excellent written and verbal communication skills.
• Superior analytic and problem-solving skills with an understanding of various clinical and financial operational processes within the healthcare industry.
• Demonstrated leadership and organizational skills with the ability to facilitate and influence decisions by motivating others to achieve excellence in both the quality of work and their approach to teamwork.
• Proven ability to monitor productivity, quality, and performance metrics while ensuring regulatory compliance.
• Proficiency with healthcare systems and technology platforms including Epic, Microsoft Office applications, and reporting tools (Excel, Tableu).
• Working knowledge of HIPAA, Medicare/Medicaid regulations, and healthcare compliance requirements.
• Experience managing multi-site Medicaid and Charity Care operations.
• Experience working directly with state Medicaid agencies and county welfare agencies.
• Lean, Six Sigma, or other process improvement experience.
• Knowledge of hospital revenue cycle operations and patient financial assistance programs.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Benefits and Perks:

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees’ physical, emotional, social, and financial health.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey—whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

Equal Opportunity Employer