The Company
athenahealth is a ~$5B software solutions company developing cloud-based practice management solutions, point of care mobile applications, and EHR systems for more than 140k small to midsized physician practices and hospitals. The company offers revenue cycle management as well as patient engagement services and clinical records management services. In 2019, a new athenahealth was formed, bringing together two companies with decades of experience in healthcare technology: athenahealth, Inc. and Virence Health. The company’s combined technology, insight, expertise, and customer base uniquely positions them to unlock and understand healthcare data from across the nation. athenahealth is headquartered in Watertown, MA.
The Role
Within its Technology Enabled Services (TES) organization, athenahealth offers services across the full end-to-end spectrum of revenue cycle management for its customers. To support the continued growth and quality of RCM offerings, athenahealth is seeking to hire a new Vice President of Rules and Configuration Services. The new VP will oversee four primary areas of the TES business, with the goal of increasing efficiency and quality of adoption and effectiveness of electronic payer transactions across the end-to-end revenue cycle:
• Knowledge and Decision Services (Rules): Increase the quality and efficacy of proprietary claim submission technology (Rules Engine) and extend RCM performance using industry standard transactions.
• Configuration Services (Enrollment): Maximize the potential of electronic payer transactions across the spectrum of the revenue cycle by optimizing enrollment and configuration services, working in coordination with the onboarding team.
• Electronic Data Interchange (EDI): Engage with senior leaders at health plan organizations to develop connectivity and processing pathways between organizations. Oversee the development of technical connections and other EDI configurations that would reduce delivery cost.
• Global Rules and Network Performance: Plan, organize, and oversee the organizational denial prevention efforts across TES to reduce revenue cycle re-work to ensure accurate reimbursement from health plans.
Experience & Requirements
• Experience in a revenue cycle operations leadership position in a healthcare company of similar size and complexity.
• Deep understanding of end-to-end revenue cycle operations, challenges, and best practices.
• Direct experience working with payers and/or clearinghouses.
• Ability to build and manage high-functioning teams, driving consistency and efficiency through leadership.
• Expertise in managing cross-functional communication and partnership. Experience leveraging product teams to drive overall results and quality of service offerings.
• Demonstrated ability to lead and influence others to achieve results.
• Experience using data and analytics to identify opportunities and risks when related to customer experience and retention.
• Exceptional analytical, organizational, and project management skills.
• Manages change through influence; capable of driving buy-in and change across a diverse set of internal stakeholders; collaborative and team-oriented.
• Excellent presence, communications, and stakeholder management skills; Credible with cross-functional teams and external partners.
