RCM Manager, Business Systems

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit www.eyecare-partners.com.

Title: RCM Manager, Business Systems

Job Summary

The RCM Business Systems Manager is responsible for overseeing critical daily operations of RCM systems with a strong focus on EDI management, ensuring complex technical and vendor issues are resolved, tracking system governance approvals, business collaboration and ongoing process/workflow improvement. This role ensures the accuracy and completeness of EDI file reconciliations, manages timely EDI claim and ERA enrollments, and coordinates the resolution of EDI production issues by collaborating with relevant teams. The manager will provide timely support by monitoring and addressing production issues, facilitating quick recovery and continuity of services through effective collaboration with RCM, IT and other necessary stakeholders.

Additionally, the role involves documenting and tracking production issues, conducting root cause analysis, and implementing preventive measures to improve system reliability. The RCM Business Systems Manager will oversee system governance related to operational changes, ensuring compliance with internal policies and industry standards, while also managing system access for partnered off-shore vendors. Regular participation in weekly escalation meetings and collaboration with cross-functional teams will be essential to align on RCM processes and explore optimization opportunities. Furthermore, the manager will lead production process improvements aimed at reducing waste and operational costs by analyzing workflows and developing strategies to enhance productivity without compromising quality standards. This position requires a proactive leader with strong Business Systems skills and a commitment to driving efficiency within the RCM department.

Duties And Responsibilities

• EDI Management:
• Oversee the reconciliation of EDI files, including claims, remittance advice, and placements.
• Ensure timely initiation and completion of EDI claim submissions and ERA enrollments.
• Manage production issues related to EDI, coordinating promptly with relevant teams to address any discrepancies.
• Issue Resolution:
• Provide timely support to the department by monitoring and addressing production issues as they arise, ensuring minimal disruption to RCM operations.
• Collaborate with IT Product Owners and relevant business stakeholders to troubleshoot and resolve system-related production issues, facilitating quick recovery and continuity of services.
• Ensure production issues are tracked and clearly communicating with impacted teams and providing updates on resolution status.
• Conduct root cause analysis for recurring production issues, working with teams to implement preventive measures and improve system reliability.
• Address system production issues promptly, working closely with IT Product Owners and vendors to escalate and resolve problems.
• Provide oversight on RCM issues reported by partnered off-shore vendors, ensuring effective communication and resolution strategies are in place.
• System Governance:
• Oversee system governance related to changes, ensuring compliance with internal policies and industry standards.
• Oversee vendor system governance on changes, ensuring that all modifications align with operational needs.
• Business and Vendor Collaboration:
• Attend weekly escalation meetings to discuss ongoing issues, progress, and resolutions with stakeholders.
• Collaborate with cross-functional teams to ensure alignment on RCM processes and system performance.
• Work collaboratively with RCM teams to identify, address, and resolve ongoing operational issues.
• Actively participate in discussions to explore optimization opportunities within RCM processes, ensuring that systems are effectively utilized to enhance overall efficiency and performance.
• Access Management: o Manage access provisioning for partnered off-shore vendors, ensuring compliance with security protocols and operational needs are met timely.
• Process Improvement Initiatives: o Identify and implement process improvement initiatives within the department aimed at reducing waste and operational costs.
• Collaborate with RCM teams to analyze current workflows, pinpoint inefficiencies, and develop strategies that enhance productivity while maintaining quality standards.
• General Duties o Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
• Performs other duties that may be necessary or in the best interest of the organization
  
  

Education, Licensure & Certification Requirements

High School or GED

Experience Requirements

• 7 years of experience in Revenue Cycle Management (RCM) systems management or a related role, with a proven track record of overseeing complex daily operations.
• 7 years of experience in complex large scale task management.
• Demonstrated experience in managing and resolving complex production issues, with a strong ability to collaborate with RCM, IT and other cross-functional teams.
• Proven experience in leading production related improvements within RCM operations, with a focus on reducing waste and optimizing efficiency.
• Experience managing large teams, both onshore and off-shore, with a strong emphasis on performance management and team development
  
  

Knowledge, Skills And Abilities Requirements

• Strong knowledge of RCM business system processes.
• Extensive experience managing large teams of onshore and off-shore staff.
• In-depth knowledge of NextGen processes, particularly from an optimization and governance standpoint.
• Excellent problem-solving skills and the ability to work under tight deadlines.
• Proven track record of effectively resolving complex operational and technical issues within RCM systems.
• Experience in conducting thorough root cause analysis with staff to identify underlying problems and implement effective resolutions.
• Strong ability to navigate and troubleshoot multifaceted system challenges, coordinating with crossfunctional teams to achieve timely resolutions.
• Familiarity with department methodologies to oversee the resolution of complex issues.
• Detail oriented, professional attitude, reliable
• Management and organizational skills to support the leadership of this function
• Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations
• Strong Interpersonal skills to support customer service, functional, and teammate support needs
  
  

 Able to communicate effectively in English, both verbally and in writing

 Ability to convey complex information clearly to diverse stakeholders and facilitate collaborative problem-solving efforts.

• Ability for basic to intermediate problem solving, including mathematics
• Intermediate to advanced computer operation
  
  

 Proficiency with Microsoft Excel, Word, PowerPoint, Access, SharePoint and Outlook

• Specialty knowledge of systems relating to job function
  
  

 ECP Patient Accounting Systems and EMR

• Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines
  
  

Supervisory Responsibilities

• Directly supervises employees both on-shore and off-shore.
• Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
• Responsibilities include interviewing, hiring, and training employees, planning, assigning, and directing work; appraising performance, rewarding and disciplining employees, addressing complaints and resolving problems.
  
  

Location/Work Environment:

For remote team members, HIPAA compliant home office environment. Ability to work in a remote environment while performing required duties and remaining patient focused. Able to work varying shifts including early mornings/evenings to attend meetings and cross training or support other initiatives

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

If you need assistance with this application, please contact (636) 227-2600

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Please do not contact the office directly – only resumes submitted through this website will be considered.