Manager, Professional Billing and Claims

Community Care Cooperative (C3); Boston (MA); On-site; USD 120,000 - 180,000; Full time

Job summary

Community Technology Cooperative (CTC), a subsidiary of Community Care Cooperative (C3), is seeking a highly motivated Manager to lead Epic systems application teams for professional billing and claims for existing customers and upcoming implementations. The Manager will be housed under CTC and report to the Senior Director of Applications.

The Epic applications include Epic's Professional Billing, SBO, Benefits Engine, Reimbursement Contracts and SBO integrations, along with third‑party

Qualifications

• Minimum 5+ years of Epic experience in professional billing, SBO and/or claims applications.
• Understanding of the overall revenue cycle from front end to back end billing.
• Experience leading multiple Epic implementations and coordinating with vendors and health centers.

Responsibilities

• Lead workflow design, building, and testing for Epic applications.
• Guide project workstreams and ensure alignment with business needs and timelines.
• Coordinate with Epic representatives, health centers, and end users to deliver value across projects.
• Regularly engage leadership to review project status and issues.
• Mentor and coach team members to build a culture of excellence and customer service.
• Manage upgrades, maintenance and new feature implementations for Epic and third‑party integrations.

Skills

Epic experience

Revenue cycle knowledge

Project leadership

Vendor coordination

Education

Bachelor's degree

Tools

Epic software suite

SBO (Single Billing Office)

Job description

Organization Summary

Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

Location: Boston, Hybrid

Organization Summary

Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

Job Summary

Community Technology Cooperative (CTC), a subsidiary organization of C3 is seeking a highly motivated Manager to lead our Epic systems application teams for professional billing and claims applications for our existing customers and upcoming implementations. The Manager of Professional Billing and Claims will be housed under a subsidiary organization of C3, Community Technology Cooperative, LLC (CTC) and reports to the Senior Director of Applications. The Epic applications for the Manager role include Epic's Professional Billing, Claims, Benefits Engine, Reimbursement Contracts and SBO (Single Billing Office) applications in addition to third-party applications. The Manager monitors and advises on various aspects of their respective applications including internal collaboration with colleagues as well as external stakeholders.

Responsibilities

• Workflow development, design, and testing for Epic applications
• Guide workflow design, building, and testing the system, and analyzing other technical issues associated with Epic software
• Partner with Epic representatives, the health centers' business community, and end users to ensure the system meets their business needs regarding the project deliverables and timeline
• Engage with appropriate leadership regularly to review the status of projects and issues
• Problem-solve concerns and escalate issues to appropriate members of the leadership team
• Work collaboratively with the leadership team of CTC and C3 towards the strategic goals of C3, CTC and the health centers that we serve
• Develop an understanding of operational needs to collaborate and set the direction for the organization's workflows
• Assist with the identification, evaluation, and assessment of new technology, developing recommendations on the impact of integration with existing workflows and systems
• Ability to manage and prioritize initiatives with competing priorities
• Demonstrate a proactive mindset with the ability to analyze and anticipate possible events prior
• Answer questions and foster enthusiasm for HIT projects within the health centers
• Maintain the scope, schedule, and quality of the project in their specific application areas and/or team
• Set clear expectations for team members, including defining what they should do at each phase of the project
• Work closely with the program manager and other project managers to coordinate activities
• Ensure that the health center community is informed and engaged with all aspects of the implementations and workflow
• Advise and coach team members by providing guidance on project issues, key success factors of the project, and lessons learned
• Develop and mentor team to build a culture of excellence, collaboration and great customer service
• Identify and document implementation issues and best practices to create a process for future implementations
• Share the positive effects of innovation and system capabilities with team members
• Reinforce the importance of the project together with the executives and the project manager, and providing consistent communication to the project team
• Appropriately matching team member skills to team responsibilities
• Manage the project from an organizational perspective while attending to detailed tasks
• Work directly with third-party vendor contacts for escalations and participating in monthly or quarterly check-ins
• Maintain contracts with third party vendors, including but not limited to monitoring volumes for overage costs, reporting of total visits and users for annual renewals
• Manage upgrades, maintenance and implementation of new features for third-party vendors
• Other duties as assigned

Required Skills

• 5+ years Epic experience in the areas of professional billing, SBO and/or claims applications in an Epic IT department
• Certification in Professional Billing with Single Business Office (SBO)
• Knowledge of the overall revenue cycle from the front end to back-end billing
• Knowledge of financial reporting
• Experience tracking financial metrics and revenue cycle activities for Epic go lives
• Ability to provide direction and oversight for simultaneous core organization projects
• Experience with a minimum of two Epic implementations required
• Proven record of accomplishment of EMR implementation and optimization of systems

Desired Other Skills

• Prior experience with FQHCs is strongly preferred
• Familiarity with the MassHealth ACO programs
• Experience with anti-racism activities, and/or lived experience with racism is highly preferred

Qualifications

• Bachelor's degree
• In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **