Sr Manager, Revenue Cycle Management Business Support - PST - Remote

Optum; Concord (CA); Remoto; USD 92.000 - 164.000; Tempo pieno

Descrizione del lavoro

Optum Insight is a leading health services company improving the revenue cycle for health systems. The Sr Manager, RCM Business Support in PST Remote will lead analytics and process improvements while partnering with cross-functional teams to drive reimbursement, cash realization, and cost efficiency.

You will monitor KPIs, manage denial prevention programs, support transformation initiatives across RCM centers, and leverage enterprise AI tools to streamline workflows with sustainable adoption

Competenze

• 5+ years of experience in Revenue Cycle Management Operations.
• 3+ years in Business Process Improvement, Consulting, Project Management, or related field.
• Experience using data/analytics to identify performance improvements.

Mansioni

• Lead analysis of front-end, mid-cycle, and back-end revenue cycle operations to identify opportunities.
• Drive CPI and KPI for continuous performance improvement initiatives.
• Lead denial management programs, identify denial trends, and reduce write-offs.
• Monitor P&L, KPIs, and client satisfaction across RCM functions.
• Translate data into actionable recommendations and implementation plans.
• Collaborate with cross-functional teams to improve reimbursement and denial prevention.

Conoscenze

Revenue cycle operations

Operations leadership

Data analytics

Project management

Change management

Leadership

Communication

Strumenti

AI tools

Data analytics tools

Descrizione del lavoro

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Sr Manager, Revenue Cycle Management Business Support - PST - Remote (2386452)

Sr Manager, Revenue Cycle Management Business Support - PST - Remote - 2386452

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

This position will support the execution of end-to-end revenue cycle service commitments for one of Optum’s Health System partnerships. The role will continuously drive client revenue cycle performance improvement, as well as cost, productivity, and profitable goals.

Success depends on driving efficiency, effective partnership, influence, and collaboration across various functions of Optum Insight ensuring initiatives and strategy are targeting delivery of world-class billing services, driving patient and customer commitment, and maximizing return through improved bad debt, cash realization, and cost efficiencies. This position is responsible for influencing change related to the key functions of Revenue Cycle through collaborative engagement with various matrixed teams to develop and support/lead initiatives that will achieve results while identifying gaps in client support/performance and proposing solutions (technology, services) to drive performance improvement.

The Sr. Manager, RCM Business Support is a key operations leader who directly supports a client delivery organization within Optum’s Market Performance Partnerships (MPP).

The Sr. Manager is responsible for enabling the adoption of enterprise Revenue Cycle Management (RCM) standards, operating models, and performance improvement initiatives and supporting day-to-day management of operational and client demands.

This role will support day-to-day operational needs across our RCM operations. The candidate will also support transformation initiatives, operational assessments, and lead implementation activities for Operations, RCM Centers of Excellence, Technology, Analytics, and Automation.

The Sr. Manager will help monitor P&L performance, KPIs, and client satisfaction across all functions in Front, Middle, and Back Revenue Cycle Management (RCM), and thrive in a matrixed, global work environment to drive RCM cost, productivity, and performance.

If you are located in PST time zone from anywhere within the U.S., you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Lead analysis of front-end, mid-cycle, and back-end revenue cycle operations to identify opportunities that improve reimbursement, cash collections, and overall financial performance
• Serve as a revenue cycle subject matter expert, partnering with operational leaders to resolve barriers impacting claim payment, account resolution, and revenue realization
• Drive CPI and KPI for continuous performance improvement initiatives through operational analysis, performance monitoring, and implementation of corrective actions
• Lead comprehensive denial management programs focused on identifying denial trends, quantifying financial impact, and reducing avoidable write-offs
• Perform detailed denial root cause analyses across patient access, authorization, medical necessity, payer policy, charge capture, billing, and claim submission processes
• Develop and implement denial prevention strategies, corrective action plans, and operational process improvements to improve first-pass payment rates and reduce denial volumes
• Oversee denial recovery efforts, including appeals prioritization, escalation strategies, payer issue resolution, and monitoring appeal success rates
• Analyze payer-specific denial and reimbursement trends to identify systemic issues, contract compliance concerns, and recovery opportunities
• Conduct A/R work queue and aging analyses to identify reimbursement barriers, prioritize resolution activities, and accelerate cash collections
• Lead revenue cycle initiatives supporting operational excellence, enterprise standardization, technology adoption, and performance improvement objectives
• Translate operational and financial data into actionable recommendations, business cases, and implementation plans that improve revenue cycle outcomes
• Partner with Patient Access, Financial Counseling, Revenue Integrity, Managed Care, and other operational teams to improve processes impacting reimbursement and denial prevention
• Facilitate cross-functional operational reviews and working sessions to address performance gaps, revenue leakage, payer challenges, and process inefficiencies
• Monitor implementation and operational performance, ensuring sustainable adoption of revenue cycle best practices and achievement of targeted financial results
• Function as both a strategic leader and hands-on contributor, personally driving analysis, stakeholder engagement, solution development, and execution of initiatives that improve net revenue performance
• Use enterprise-approved AI tools to streamline workflows, automate tasks and drive continuous improvement

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 5+ years of experience in Revenue Cycle Management Operations
• 3+ years of Business Process Improvement, Consulting, Project Management, or a related field
• Experience utilizing data and analytics to identify performance improvement opportunities and support decision-making
• Demonstrated experience driving projects and introducing technology to improve client performance and operational efficiency
• Demonstrated experience facilitating organizational change and providing process improvement recommendations
• Experience leading operational improvement, implementation, transformation, or process standardization initiatives
• Working knowledge of revenue cycle operations, workflows, performance metrics, and operational best practices
• Proven ability to analyze complex market opportunities and develop creative solutions
• Willing or ability to travel to client locations if not located in Bay Area

Preferred Qualifications:

• Experience working within a global organization
• Proven excellent communication, leadership, customer service, and problem-solving skills

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.