Clinical Pathways Manager

Expert Recruitment; United States; Remote; USD 115,000; Full time

Job summary

A leading ophthalmology and retina practice seeks a Clinical Pathways Manager to optimize revenue cycle management initiatives. This remote role, requiring approximately 20% travel, involves developing clinical pathways to enhance patient outcomes and financial performance. Candidates should have at least five years of experience in a leadership role within ophthalmology, along with strong analytical and communication skills.

Benefits

Comprehensive benefits package

Flexible remote work

Qualifications

• Minimum of five years in revenue cycle leadership within an ophthalmology or retina practice.
• Bachelor's degree in related field; CPC preferred.
• Proficiency in ophthalmology-specific EHR and PM systems.

Responsibilities

• Lead and manage RCM initiatives across multiple practice locations.
• Collaborate with teams to design and implement clinical pathways.
• Monitor KPIs related to clinical pathways and revenue cycle processes.

Skills

Analytical skills

Communication

Knowledge of coding and billing

Education

Bachelor's degree in Healthcare Administration

Certified Professional Coder (CPC)

Tools

Ophthalmology-specific EHR systems

Billing software

Job description

Clinical Pathways Manager
Remote Role with 20% Travel
Salary: Up to $115,000 DOE + 15% Bonus

Position Overview

We are seeking a dynamic and experienced Clinical Pathways Manager tolead and optimize revenue cycle management (RCM) initiatives acrossour multi-physician, multi-location ophthalmology and retina practice.This fully remote role with approximately 20% travel offers anexciting opportunity to influence clinical and financial outcomes in agrowing, specialized healthcare organization.

Reporting directly to the Vice President of Revenue Cycle Management,the Clinical Pathways Manager will be responsible for developing,implementing, and refining clinical pathways that align with bestpractices, enhance patient outcomes, and drive financial performance.This role requires a strategic thinker with a deep understanding ofophthalmology and retina-specific coding, billing, and reimbursementprocesses.


Key Responsibilities

Revenue Cycle Optimization:
Lead and manage RCM initiatives across multiple practice locations,ensuring accurate and timely billing, coding, and reimbursement forophthalmology and retina services.

Clinical Pathway Development:
Collaborate with clinical and administrative teams to design andimplement evidence-based clinical pathways that standardize care,improve patient outcomes, and enhance operational efficiency.

Stakeholder Collaboration:
Work closely with physicians, practice leaders, and other departmentsto ensure alignment of clinical pathways with organizational goals andregulatory requirements.

Performance Monitoring:
Establish and monitor key performance indicators (KPIs) related toclinical pathways and revenue cycle processes, using data to drivecontinuous improvement.

Compliance and Education:
Ensure adherence to federal, state, and payer-specific regulations,providing training and support to staff on clinical pathway protocolsand RCM best practices.

Process Improvement:
Identify opportunities for process enhancements within the revenuecycle and clinical pathways, leading initiatives to streamlineworkflows and reduce inefficiencies.

Reporting and Analysis:
Prepare and present regular reports on clinical pathway performance,financial metrics, and project milestones to senior leadership.


Qualifications

Experience:
Minimum of five (5) years in a revenue cycle leadership positionwithin an ophthalmology or retina practice, with a proven track recordof managing RCM operations and implementing clinical pathways.

Education:
Bachelor's degree in Healthcare Administration, BusinessAdministration, or a related field. Advanced certifications (e.g.,
Certified Professional Coder (CPC)) are preferred.

Technical Skills:
Proficiency in ophthalmology-specific electronic health record (EHR)and practice management (PM) systems. Familiarity with coding andbilling software relevant to ophthalmology and retina care.

Analytical Abilities:
Strong analytical skills with the ability to interpret complex data,identify trends, and implement data-driven solutions.

Communication:
Excellent verbal and written communication skills, with the ability toeffectively collaborate with diverse teams and stakeholders.

Travel Requirements:
Willingness to travel approximately 20% for on-site visits, training,and meetings.


Compensation and Benefits

Salary:
Competitive base salary up to $115,000, commensurate with experience.

Bonus:
Eligibility for an annual performance-based bonus of up to 15%.

Benefits:
Comprehensive benefits package.


Why Join Us?

This is a unique opportunity to play a pivotal role in shaping thefuture of clinical care and financial performance in a leading
ophthalmology and retina practice. As a remote Clinical PathwaysManager, you will have the flexibility to work from home whilecontributing to the success of a dynamic and growing organization.

If you are a strategic leader with a passion for optimizing clinicalpathways and revenue cycle processes, we invite you to apply and be part of our innovative team.

Compensation:
$115,000 per year