Manager Provider Enrollment/BI - Baystate Health
Springfield, MA
About the Job
Summary:
Schedule: Monday-Friday 8a-430pm (hybrid option)
Location: 280 Chestnut Springfield MA
The incumbent is responsible for coordinating back office support activities related to the maximization of net service revenue and third party incentives resulting from the activity of Baystate Medical Practices' providers. Included in this endeavor is the analysis of eligibility and registration of providers in numerous incentive programs, including the CMS EHR Meaningful Use program. Support through the development of analytical tools and reports allows the incumbent to perform program eligibility analysis, forecasting of budgets, generation of provider-centric reports and dashboards, and net revenue modeling. The Manager, Provider Enrollment and Business Intelligence also oversees provider registration in government incentive programs as well as the ongoing enrollment of 1,000+ providers with third party insurers, government payers and external agencies. The position serves as the primary contact between BMP and Massachusetts eHealth Institute (MeHI) and serves as a Delegated Official with CMS for the purpose of enrolling providers.
Staff support for these functions includes the following direct reports: a financial analyst, a database analyst, a supervisor of provider enrollment and several staff enrollment specialists and associates - nine exempt FTEs in all. Inherent in this position is the need to generate reports and analyses that support the financial close and other decision-making processes related to the BMP physician corporation. Accountabilities include maintaining and maximizing information delivery systems in order to ensure the efficient flow of provider, financial and operational data, creating databases and business intelligence tools to track and manage performance, and analyzing the impact of regulatory, incentive and reimbursement changes. The incumbent coordinates all ad hoc data requests and develops both the business requirements as well as the means of information delivery. Analyze, prioritize and coordinate projects between multiple units/departments and also between departments and external payers.
Job Responsibilities:
1) Oversees the activity of Provider Enrollment staff, including enrollment, re-enrollment, termination, practice and panel changes, and roster maintenance, for all physicians, advanced practitioners, residents and fellows.
2) Working with Finance and the Clinical IT team, coordinates MPBS efforts to register and attest for Meaningful Use eligibility. Tracks and reports MU financial performance.
3) Leads reporting efforts of financial and database analysts, including prioritization of work. Develops and trains analysts as needed.
4) Develops databases and business intelligence solutions to facilitate standard and ad hoc data requests.
5) As a member of the MPBS management team, performs root cause analysis and recommends process improvement efficiencies.
6) Independently reviews government and third party payer regulations regarding various incentive (non FFS) programs and models the impact of such programs to BMP.
7) Models and analyzes the impact of fee schedule updates and WRVU changes to BMP providers and service areas.
8) Provides analytical support to the central billing office, finance, compliance, and managed care teams and leadership. Supports the initiatives of RMOG and other revenue advisory committees.
9) Analyzes operational issues related to professional billing, including denial analysis, payer effectiveness and contract compliance.
10) Coordinates projects assigned to financial analyst work team and prioritizes team workload. Serves as System Administrator of BH intranet publishing site (HBI).
11) Validates the accuracy of all published data requests, reports and dashboards
12) Responsible for complex analysis of revenue generating functions
13) Manages staff productivity and resolves conflicts when necessary
14) Incumbent is expected to adhere to System and department compliance policies and any and all applicable laws and regulations
You Belong At Baystate
At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
Education:
Bachelor of Science: Computer and Information Science (Required)
Certifications:
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
Ab out Baystate Health
Baystate Health (BH) is one of New England’s leading and largest integrated health care organizations, serving a population of nearly one million people throughout western New England. With roots dating back to the founding of Springfield City Hospital in 1873, Baystate Health has been providing high-quality and compassionate health care in western Massachusetts for more than 145 years. With more than 12,000 employees, a medical staff of nearly 3,100 physicians, and a net patient service revenue of more than $1.4 billion, the ever-growing health system includes five Massachusetts hospitals and the Baystate Mary Lane Outpatient Center in Ware:
+ Baystate Medical Center in Springfield
+ Baystate Children’s Hospital (located at Baystate Medical Center)
+ Baystate Franklin Medical Center in Greenfield
+ Baystate Wing Hospital in Palmer
+ Baystate Noble Hospital in Westfield
Schedule: Monday-Friday 8a-430pm (hybrid option)
Location: 280 Chestnut Springfield MA
The incumbent is responsible for coordinating back office support activities related to the maximization of net service revenue and third party incentives resulting from the activity of Baystate Medical Practices' providers. Included in this endeavor is the analysis of eligibility and registration of providers in numerous incentive programs, including the CMS EHR Meaningful Use program. Support through the development of analytical tools and reports allows the incumbent to perform program eligibility analysis, forecasting of budgets, generation of provider-centric reports and dashboards, and net revenue modeling. The Manager, Provider Enrollment and Business Intelligence also oversees provider registration in government incentive programs as well as the ongoing enrollment of 1,000+ providers with third party insurers, government payers and external agencies. The position serves as the primary contact between BMP and Massachusetts eHealth Institute (MeHI) and serves as a Delegated Official with CMS for the purpose of enrolling providers.
Staff support for these functions includes the following direct reports: a financial analyst, a database analyst, a supervisor of provider enrollment and several staff enrollment specialists and associates - nine exempt FTEs in all. Inherent in this position is the need to generate reports and analyses that support the financial close and other decision-making processes related to the BMP physician corporation. Accountabilities include maintaining and maximizing information delivery systems in order to ensure the efficient flow of provider, financial and operational data, creating databases and business intelligence tools to track and manage performance, and analyzing the impact of regulatory, incentive and reimbursement changes. The incumbent coordinates all ad hoc data requests and develops both the business requirements as well as the means of information delivery. Analyze, prioritize and coordinate projects between multiple units/departments and also between departments and external payers.
Job Responsibilities:
1) Oversees the activity of Provider Enrollment staff, including enrollment, re-enrollment, termination, practice and panel changes, and roster maintenance, for all physicians, advanced practitioners, residents and fellows.
2) Working with Finance and the Clinical IT team, coordinates MPBS efforts to register and attest for Meaningful Use eligibility. Tracks and reports MU financial performance.
3) Leads reporting efforts of financial and database analysts, including prioritization of work. Develops and trains analysts as needed.
4) Develops databases and business intelligence solutions to facilitate standard and ad hoc data requests.
5) As a member of the MPBS management team, performs root cause analysis and recommends process improvement efficiencies.
6) Independently reviews government and third party payer regulations regarding various incentive (non FFS) programs and models the impact of such programs to BMP.
7) Models and analyzes the impact of fee schedule updates and WRVU changes to BMP providers and service areas.
8) Provides analytical support to the central billing office, finance, compliance, and managed care teams and leadership. Supports the initiatives of RMOG and other revenue advisory committees.
9) Analyzes operational issues related to professional billing, including denial analysis, payer effectiveness and contract compliance.
10) Coordinates projects assigned to financial analyst work team and prioritizes team workload. Serves as System Administrator of BH intranet publishing site (HBI).
11) Validates the accuracy of all published data requests, reports and dashboards
12) Responsible for complex analysis of revenue generating functions
13) Manages staff productivity and resolves conflicts when necessary
14) Incumbent is expected to adhere to System and department compliance policies and any and all applicable laws and regulations
You Belong At Baystate
At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
Education:
Bachelor of Science: Computer and Information Science (Required)
Certifications:
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
Ab out Baystate Health
Baystate Health (BH) is one of New England’s leading and largest integrated health care organizations, serving a population of nearly one million people throughout western New England. With roots dating back to the founding of Springfield City Hospital in 1873, Baystate Health has been providing high-quality and compassionate health care in western Massachusetts for more than 145 years. With more than 12,000 employees, a medical staff of nearly 3,100 physicians, and a net patient service revenue of more than $1.4 billion, the ever-growing health system includes five Massachusetts hospitals and the Baystate Mary Lane Outpatient Center in Ware:
+ Baystate Medical Center in Springfield
+ Baystate Children’s Hospital (located at Baystate Medical Center)
+ Baystate Franklin Medical Center in Greenfield
+ Baystate Wing Hospital in Palmer
+ Baystate Noble Hospital in Westfield
Source : Baystate Health