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
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