Senior Manager Case & Escalation Management

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Position Summary: Revenue Cycle Case and Escalation Management (RCCEM) is the end of the line escalation team researching and resolving our most complex and sensitive client issues. RCCEM is the horizontal team responsible for driving actionable insights across Operations by providing visibility into the services we deliver, ensuring they align to athena’s value proposition and the service our customers expect. The Revenue Cycle Case Escalation & Management (RCCEM) Team is an important part of ensuring that when a client has a complex issue it is quickly, accurately, and effectively resolved. The RCCEM Manager strives to create visibility into case performance across Operations, driving consistency in terminology and measurement while championing our efforts to improve case resolution performance and the impact those efforts are delivering.

Essential Functions (Duties and Responsibilities):

• 60% Lead the case escalation team (Most important job duty): Support the RCCEM mission and vision by supporting the Case Escalation & Management (CEM) program.
  • Visibility into cases and performance management
  • Curation of the issue management process, including triage and governance (ensure everything is captured)
  • Strong collaborative cross functional partnerships across the stakeholder ecosystem, including Client Success, TES Service Integrity and Delivery, and the Product organization
  • Create excitement and help drive a revolution in how athena views, prioritizes and treats client issues
  • Coach and groom the team to perform at the top of their license
• 15% Influence Roadmaps: Leveraging strong cross functional partnerships to advocate for changes to service delivery, service offerings and/or product.
  • Support RCCEM by telling the “impact story” by developing and socializing comprehensive business cases
  • Use business cases to create a strong sense of client benefit to facilitate effective advocacy
  • Track implemented changes to validate desired results
• 15% Pursue Better Outcomes for Clients: Ensure the team pursues opportunities to reduce case inflow and improve client sentiment by: creating training and/or communication materials; suggesting workflow and quality improvements to the proper teams; or otherwise driving fellowship with client-facing teams and clients.
• 5% RCCEM Project Management and Data analysis: Support Operations by driving all to adhere to the standardized issue reporting process governed by athenaNation’s single source of truth.  
  • Ensure the right types of information are being used to enable analysis of issues so actionable insights can be gleaned  
  • Provide case analysis and comprehensive client sentiment trends and drivers   
  • Work closely with peers, partner teams and clients to identify root cause and agreed upon solutions   
  • Business cases should initiate formal charters and should include a summary of the business problem, the suggested approach to resolve, why it is important to our customers and our business, success statement, strategic alignment and what should be in and out of scope 
  • Apply comprehensive project management skills to manage project life cycle to ensure top quality deliverables

• 5% Client issue management : Support and drive improvements in client issue management by overseeing our single point of entry issue management system within Salesforce, ensuring team is focused on meeting or exceeding expected TAT and quality through close collaboration with client-facing and operational teams. Once clear drivers of client issues have been identified, facilitate team outreach to appropriate operational teams to improve client outcomes. Upon completion of specific issue resolution, ensure solutions and results can be communicated to clients as needed.

Education & Experience Required:

• An ideal candidate will have medical billing/US healthcare experience or have demonstrated the ability to rapidly learn the foundational concepts of US healthcare and medical billing
• All candidates must possess a strong desire to learn, as well as embrace athenahealth's unique problem-solving and creative-solutions based approach to our work
• Applicants should be excited by the prospect of working in a dynamic and collaborative environment of continual change/improvement, driven by our rapid rate of growth
• As such, qualified candidates must possess strong analytical, communication, and organizational skills, and be very detail oriented to provide on-going support of client performance
• Bachelor's degree or equivalent experien