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Revenue Cycle Business Performance Manager

Firefly Health

Firefly Health

Watertown, MA, USA
Posted on Saturday, November 18, 2023

Be a part of the team building the future of healthcare!

Firefly Health is building a revolutionary new type of comprehensive health "care and coverage,” powered by a relationship-driven care team, a trusted virtual and in-person clinical network, and our proprietary technology platform.

Founded by experienced clinicians and technology leaders, Firefly Health is on a mission to deliver half-priced health care that's twice as good, clinically and emotionally. We are flipping the script on what it means to be a health plan and actually providing a true health benefit to members.

We are intensely focused on optimizing the physical + mental + financial wellbeing of those who want (and deserve) something better than the status quo. If you are ready to roll up your sleeves and take on our audacious mission, then we would love to hear from you.

Your Role

As the Revenue Cycle Business Performance Manager, you will work alongside the CFO, Chief of Staff, Clinical Leadership, and other internal stakeholders day-to-day to improve the performance of revenue cycle management within the business. This role will be responsible for current key management performance/process reporting & assist in significantly enhancing this area to provide more meaningful analysis & process improvements

You will:

  • Provide development and implementation of programs and initiatives to improve the accuracy of the coding, including education; and vendor contract management
  • Identify critical process opportunities for enhancement and propose tangible solutions to avoid repeatable errors
  • Gather operational and workflow requirements to document, implement and monitor workflow processes
  • Implement, document, and monitor business processes and associated workflow automation and applications
  • Perform retrospective review of medical records to ensure appropriate documentation supporting diagnoses submitted and to identify opportunities for improving member risk adjustment score accuracy

You’d be a good fit if you have:

  • Bachelor’s in business administration, healthcare administration, finance, or related field required
  • 5+ years of revenue cycle or risk coding management experience
  • Strong functional expertise in coding and healthcare revenue cycle with demonstrated experience working in a fast-paced environment
  • Strong written and oral presentation skills and interpersonal skills
  • Advanced knowledge around Excel, SQL, and other data tools
  • Ability to manage multiple projects simultaneously, and work in a fast-paced environment
  • Strong analytical, organization, presentation, and problem-solving skills
  • Knowledge of billing systems and healthcare coding and experience working with healthcare claim data
  • Advanced troubleshooting abilities, with ability to problem solve complex technical issues

It’d be nice if:

  • You have experience working in a healthcare provider administering services in a Value Based arrangement or other full risk construct
  • You have experience working with medical coding, risk adjustment, and billing.
  • The following licensure(s), certification(s), registration(s), etc., Certifications in professional coding and risk adjustment coding from American Academy of Professional Coders

Our office is located in Watertown, Massachusetts but we’ve developed a robust remote working structure to give us more flexibility geographically while hiring for many positions.

This role can be done largely remotely, there are several times a year when staff come together onsite for planning and team building.

We are always looking for valuable talent to add to our growing team. Even if you’re not sure this role is the one for you, don’t let that stop you. We’d love to have a conversation to see where you could fit.

Firefly is an equal opportunity employer. We value diverse backgrounds and perspectives. We're committed to building and sustaining an inclusive workplace culture where individuals are treated with dignity and respect. All employment is decided on the basis of qualifications, merit, and business need.