**Become a part of our caring community and help us put health first** Associate Director will lead the Revenue Cycle Management team for the CenterWell Senior Primary Care Organization. This individual will manage a small internal team of associates and third-party RCM vendors that runs all RCM activities. Responsible for leading ongoing efficiency and effectiveness of the team through new processes, and technology. Maintaining all staff up to date on all state, federal and internal policies and procedures. Establishes industry best practices and KPIs for billing and, cash collections for both patient and payers. Innovative leader that will integrate new AI and automated solutions to drive efficiency and performance. This role will report directly into the Associate Vice President, Central Operations. The Associate Director is responsible for internal revenue cycle management (RCM) teams and third-party RCM vendors. Responsible for leading ongoing efficiency and effectiveness of the team through new processes, and technology. Maintaining all staff up to date on all state, federal and internal policies and procedures. Establishes industry best practices and KPIs for billing and collections for both patient and payers. Innovative leader that will integrate new AI and automated solutions to drive efficiency and performance. **Use your skills to make an impact** **Job Functions** + Responsible for day-to-day operations of centralized RCM offerings and Medicare Advantage financial recoveries through health plan contestations process. + Oversee the preparation of monthly reports on department activities including productivity, collections, status of accounts receivable and unbilled revenues. + Lead RCM integration responsibilities for Mergers and Acquisitions and DeNovo medical centers + Collaborate closely with all departments in the Primary Care Organization (including Operations, EMR/Technology, Clinical, Medical Coding, Credentialing, Contracting, Legal and Compliance) + Facilitate revenue and receivable meetings between RCM leadership and business partners + Ensure external vendor and internal RCM compliance with all billing and collections guidelines, hold them accountable to SLAs and manage KPI and metrics performance + Support and/or lead the implementation of process, procedure and systems to drive value in the Centralized Billing Office (CBO) including EMR/PM systems. + Maintain Standard Operations Procedures for RCM functions: claims management, accounts receivable follow-up, internal collections, collection agencies, vendors, bad-debt and administrative write-offs + Ensure the timely and accurate production and distribution of patient bills and statements. + Ensure patient questions and concerns managed by CBO are addressed in a professional and timely manner. **Required Qualifications** + Bachelor's Degree + Must have 5 or more years of Revenue Cycle Management leadership experience + This is a Remote position, travel less than >10% **Preferred Qualifications** + Thourough comprehension of third-party contracting terms with respect to Medicare (Traditional and Medicare Advantage), Medicaid, HMOs, PPOs, and a thorough knowledge of third-party billing and reimbursement. + Previous experience in billing for Risk and FFS providers, preferably with senior primary care patient populations + Demonstrated success in managing a large scale, high volume, complex billing and collections operation. + Experience with clearinghouse relationships, third party billing and collections vendors, compliance and EMRs + Lead with a clear orientation towards compliance in all aspects of the RCM process + Highly effective written and verbal communication + Analytical ability, conceptual skills to refine existing RCM operations and drive KPIs and metrics. + Advanced Excel Skills + Experience in project implementation + Strategic and analytic skills oriented with the ability to perform root cause analysis and recommend improve processes and procedures **Additional Information** This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. **Benefits** : Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: + Health benefits effective day 1 + Paid time off, holidays, volunteer time and jury duty pay + Recognition pay + 401(k) retirement savings plan with employer match + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Alert:** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $94,900 - $130,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About Us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources