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An established industry player is seeking a Program Manager of Pricing Strategies to enhance healthcare pricing and budget management. This remote role involves analyzing financial data, collaborating with vendors, and developing strategic pricing initiatives. You will play a pivotal role in ensuring compliance with billing regulations while optimizing revenue generation. If you have a strong background in healthcare revenue management and are adept at using SQL and Epic systems, this position offers a unique opportunity to make a significant impact in a supportive and innovative environment.
At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.
This is a remote/work from home opportunity! The associate should:
1) Live + work within the continental United States (required)
2) Be open to working eastern time zone hours (preferred)
Primary Function/General Purpose of Position
The Program Manager of Pricing Strategies is responsible for collecting and monitoring the organization’s pricing, expense, and budget data. This includes, but is not limited to, collaborating with the vendor responsible for the organizational Charge Description Master (CDM), and maintaining Price Transparency and annual updates. This position will also contribute to the development of strategic pricing of retail services through bundling of services offered to the communities we serve.
Essential Job Functions
Support Finance and leadership teams in analyzing budgets, revenue changes, and fiscal activities to identify trends, ensure compliance, and recommend improvements for revenue generation and expense reduction.
Manage data modeling and query processes (e.g., SQL, EPIC Clarity) to derive actionable insights supporting strategic pricing, vendor assessments, and other initiatives.
Contribute to the development and maintenance of pricing strategies, including strategic bundling of medical services, analysis of payer contracts, and competitive fee reviews.
Review and update the chargemaster to ensure accuracy, compliance with billing regulations, and alignment with industry standards.
Research and recommend updates to policies and procedures related to charge capture, price estimates, and billing compliance.
Collaborate with operational leaders and vendors to manage charge descriptions, cost center assignments, EPIC charge entry, and reimbursement impacts.
Oversee CMS and commercial payer updates, ensuring compliance with federal and state guidelines for price transparency and timely communication across the ministry.
Research and implement pricing strategies for shoppable services, including surgery pricing schedules and market expansion opportunities.
Provide analytical support to leadership, legal, and audit teams to address billing and compliance issues, and communicate updates to affected departments.
Perform ad hoc analyses to address questions from leadership, develop relationships with key stakeholders, and maintain knowledge of revenue cycle processes.
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.
Education
Bachelor’s degree in business, healthcare administration, or related field (required)
Work Experience
2+ years’ experience using Microsoft Office programs, role-specific software programs, and SQL, especially for the use of performing complex analysis of data and database maintenance (required).
Previous experience using Epic hospital, physician, and ambulatory resolute models (required).
4+ years’ experience in healthcare revenue cycle or revenue management (preferred).
Working knowledge of CPT/HCPCS, UB-04 Revenue Coding, modifiers, billing regulations, DRG’s and APCs (preferred)
Understanding of the CDM and its relationship to related areas such as the General Ledger, cost Accounting, Productivity, Cost Reporting and Budget (preferred).
Knowledge of clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology (preferred).
Working Conditions
Periods of high stress and fluctuating workloads may occur.
Long-distance or air travel as needed- not to exceed 10% travel.
General work at home office environment.
Prolonged periods of working alone.
Skills
Hard/Tech/Clinical Skills:
Budgeting & Financial Acumen
Advanced Microsoft Office Suite
Analyzing data or information
Communication, presentation
SQL working with large data sets
Build reports in Epic, Slicer Dicer, Revenue Cycle Analytics
Meeting deadlines
Soft/Interpersonal Skills:
Attention to detail
Critical thinking
Problem Solving
Teamwork
Active listening
Relationship building
Organization and planning
Prioritization Time management
Ability to work independently and collaboratively
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com