[Remote] Senior Consultant - Finance and Operations - Revenue Cycle

Note: The job is a remote job and is open to candidates in USA. Health Management Associates is seeking a Senior Consultant in the Finance & Operations – Revenue Cycle Practice. This role involves providing expertise in healthcare revenue cycle operations, including medical coding, billing, and performance improvement, while managing client relationships and leading project initiatives.

Responsibilities

• Client management
• Meets with clients and colleagues to understand requirements
• Gathers and organizes information about the issue to be solved or the procedure to be improved
• Analyzes data to identify and understand issues to be addressed
• Presents findings to internal colleagues, and clients
• Provides advice, implementation plans, and/or suggestions for improvement, according to project objectives
• Evaluates client needs, as warranted, and adjusts as appropriate
• Ensures that all deliverables are high-quality in all aspects (content, grammar, presentation, etc.)
• Serves as a subject matter expert on projects
• Project management
• Undertakes internal and external short-term and/or long-term project management to address identified issues and needs
• Develops and documents tools, analysis, frameworks, tracking tools, road maps, dashboards, and/or other approaches to manage a variety of large and small projects
• Business development
• Supports firm business development activities to expand funded work from existing clients and/or new clients
• Develops and maintains a pipeline of future work
• Participates in competitive and/or non-competitive proposal development and submission
• Leadership
• Leads and manages teams, provides developmental feedback, and advances internal initiatives
• Serves as a mentor for other staff members, as requested
• Performance metrics
• Ensures performance meets or exceeds HMA expectations in the following areas:
• Billable hour target attainment
• Manages to budget/project caps established at the outset or assists in negotiating additional fees
• Meets quality and operational standards
• Participates in internal activities related to business strategies, forecasts, adoption of new technologies/platforms/approaches, and other process improvements
• Completes administrative requirements of the role in a punctual manner, including training, reporting, timesheets, expense reports, forecasting, and all other time-sensitive administrative duties
• All other duties as assigned
• Provide accurate, timely guidance on detailed coding and billing questions across a wide variety of provider organizations
• Support FQHC billing and reimbursement improvement projects
• Advise providers on Medicaid and Medicare billing requirements and considerations
• Support revenue cycle improvement projects for hospitals, ambulatory and behavioral health providers
• Analyze large data sets and benchmark key performance indicators
• Interpret data trends to identify root causes of revenue cycle performance issues
• Translate analytical findings into improvements that drive measurable financial impact
• Identify operational bottlenecks and underutilized system functionality
• Translate complex operational and data insights into clear recommendations

Skills

• Demonstrated expertise in healthcare revenue cycle operations, medical coding, billing, reimbursement, and performance improvement
• Technical knowledge, consulting experience, and analytical capabilities needed to advise healthcare organizations
• Minimum of a bachelor's degree in business management, public health, or a related discipline
• Equivalent work experience in lieu of a bachelor's degree may be determined as acceptable
• A master's degree in a related discipline is strongly preferred
• Minimum of 5 years of progressively increasing prior experience in work involving publicly funded healthcare including policy, administration, operations, compliance, research, consulting, or evaluation
• Strong project management skills
• Solid time management skills
• Excellent attention to detail
• Ability to multi-task and adhere to strict deadlines
• Capable of handling confidential information in a discreet manner
• Ability to work extended hours when deadlines are approaching
• Excellent internal and excellent professional networking skills
• Excellent critical thinking skills
• Exceptional oral and written communication skills
• Superior interpersonal skills, including leadership, contribution to culture, and acceptance of accountability
• Demonstrated thought leadership and deep expertise in more than one critical healthcare area
• Ability to maintain an approach to stay current in trends in areas of subject matter expertise
• Certification as a Certified Outpatient Coder (COC) or Certified Professional Coder (CPC)
• Significant experience practicing as a medical coder
• Deep expertise working within the Federally Qualified Health Center (FQHC) environment
• At least 3 years of prior management consulting experience in healthcare revenue cycle
• Prior work experience in healthcare administration and/or revenue cycle operations
• Minimum of 7 years of progressive experience in healthcare revenue cycle, billing, and coding
• Certified Outpatient Coder (COC) and/or Certified Professional Coder (CPC) with at least 3 years as a practicing coder
• Demonstrated expertise in Medicare and Medicaid billing rules, claims and enrollment; Medi-Cal experience preferred
• Advanced data analytics skills, including financial modeling, complex formulas, and data validation techniques
• Advanced Microsoft Excel proficiency, including pivot tables, complex formulas, data modeling, and structured data analysis; experience with SQL is a bonus
• Strong understanding of industry-standard revenue cycle key performance indicators and benchmarks
• Demonstrated ability to apply project management techniques, including workplans, status reporting, resource management, and quality management
• Ability to work effectively both independently and in collaborative team environments

Company Overview