RCM Payer Performance Policy and Escalation Manager

Description

Professional - Nonclinical
Req #: 88414

#LI-Rmote

Is your world driven by actionable intelligent? Ours is... The Payer Performance Team is responsible for converting payor and revenue cycle management information, system data, and subject matter expert input into actionable intelligence for denial prevention/reduction & reimbursement protection. If this mission resonates strongly with you, we would love to hear from you!

Summary:

The RCM Payer Performance Policy and Escalation Manager is responsible for coordinating payer performance initiatives across the Revenue Cycle. This role facilitates a unified and accurate presentation of data and project related work as it pertains to payer policy impacts, payer claim resolution projects, and coverage research that impact payer performance, claim resolution, contract adherence, clinical initiatives, and reimbursement accuracy.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education:Bachelor's degree in business, finance, healthcare administration, or related field. May accept a combination of management and technical experience equivalent to a degree
2. Experience:3 to 5 years in revenue cycle operations, payer relations, auditing and appeals, medical insurance, or other healthcare experience. Experience in a multi-facility or integrated health system preferred.
3. Additional Skills/Requirements Required: Proficiency in data visualization and reporting tools, such as Excel, SmartSheets, Epic

Additional Information

MaineHealth is committed to fostering a supportive, inclusive environment where care team members can thrive while making a meaningful impact in the communities we serve across Maine and New Hampshire. We offer competitive benefits including paid parental leave, flexible work options, student loan assistance, professional development opportunities, and well-being resources-so you can grow your career while feeling supported both personally and professionally.

We recognize the value each team member brings to our organization.Any offer of employmentwill depend onqualificationssuch asskills, relevant experience, education, certifications,and otherjob-relatedfactors. Thebase rangeis an estimate and does notreflect the full valueofourtotal compensationpackage.

The pay range for this position is $71,448.00to $96,636.80per year.

Compensation for part-time positions isdeterminedon a prorated basis consistent with the scheduled hours and applicable full-time equivalent (FTE).

In addition to base pay, MaineHealth offerscomprehensivebenefits, recognition programs, career growth opportunities, and,where applicable,shiftdifferentials or other incentives.

If you have questions about this role, please contact kaye.cross@mainehealth.org

Hiring Scam Alert

MaineHealth will never request financial information during the interview or pre-hiring process. All legitimate communications will come from an email address ending in @mainehealth.org. If you suspect fraudulent activity, please report it immediately to mhcareers@mainehealth.org.

Notice Regarding Maine Employer Surveillance Statute:Pursuant to Maine's Employer Surveillance Statute, prospective care team members are notified that MaineHealth may monitor, collect, record, review, or retain information related to the use of its systems, networks, applications, files, data, communications platforms (including notified recordings), smart badges, building access, company vehicle GPS data, business calls, and workplace security cameras.

Information collected may be used for legitimate business purposes, including security, safety, compliance, investigations, training, quality assurance, and operational management.