Revenue Cycle Manager

Omada Health is on a mission to inspire and engage people in lifelong health, one step at a time.   Revenue Cycle Manager Omada Health is on a mission to inspire and engage people in lifelong health, one step at a time.   We’re seeking a revenue cycle manager to partner with the existing team to improve Omada’s revenue cycle management (RCM) function. The manager will be expected to understand Omada’s RCM framework, and join the RCM team in developing effective methods, tools, and systems to drive cash collections. This includes not only performing day-to-day tasks, but also coming up with strategies on how to scale revenue cycle practices in an efficient and effective way.  The manager will work with internal and external stakeholders to ensure aspects of claims billing and collection processes are in place to support our mission. Your work will ensure that Omada recovers its claims in a timely fashion, our payers are impressed with our service, and our members can focus on improving their health. This position will be at the forefront of defining the company’s processes, best practices, and systems to further support Omada’s financial growth.    Your impact:  Design and implement RCM processes and systems, with a focus on our Physical Therapy program to improve cash flow and ensure industry standard clean claim submission rate Educate customers and internal stakeholders on how to integrate with Omada’s unique billing model Project manage cross-functional efforts to increase efficiency and effectiveness of systems and processes related to the revenue cycle Create and implement policies and procedures that not only improve reimbursement but also improve the user experience Ensure claims and billing generation is completed accurately and timely and reconciles with Accounting records Provide feedback on Omada’s CPT code strategy and ensure our virtual-first healthcare services can be accurately billed with appropriate codes Build out Accounts Receivable and Bad Debt Reserve goals to achieve department and company goals Ensure all policies, procedures, and initiatives are handled in compliance with HIPAA privacy and applicable healthcare compliance and security regulations   Responsibilities Process and systems implementation Devise method and reporting to monitor, assess, and act on KPIs Internally report on key revenue cycle metrics such as claim denials or underpayments, but also identify ways to improve and avoid these moving forward Participate in claim submission and follow-up Strategize on methods to improve all functions of RCM including insurance verification, billing, etc. Collaborate with Omada’s clearinghouses on all issues related to claims management Partner with the RCM Director, Product, and Engineering on future system implementations and integrations Identify opportunities for automation and unlocking opportunities at scale RCM operations Identify and troubleshoot software-related billing issues Partner with the RCM team to devise bank reconciliation, refund, and follow-up processes for the MSK program Troubleshoot and correct any ad-hoc claim rejections, verify user eligibility, and re-submit claims accordingly Investigate, document, and take action on denials and/or underpayments Optimize existing processes for collections, especially member responsibility Monitor member collections AR and respond to escalations Documentation, training, and ongoing communication Communicate cross-functionally with Commercial teams as well as external stakeholders on how to integrate with Omada’s revenue cycle platform Propose policies, such as bad debt for Omada’s Physical Therapy offering Create robust documentation around RCM practices at Omada   Strong candidates for this position will have the following: 5+ years of experience with revenue cycle systems Passion for Omada’s mission Knowledge of the US healthcare system and the startup work environment Knowledge of industry terminology and best practices Ability to develop fantastic relationships with both internal and external stakeholders Ability to engage with all levels of an organization and different types of teams (executive, technical, finance, product, etc.) Intermediate to advanced Excel skills Attention to detail and exceptional organizational skills Excellent written, verbal, and presentation communication skills Ability to handle repetitive tasks, and continue to find ways to make processes more efficient Ability to balance day-to-day execution with long-term priorities Proficient about basic accounting and business management knowledge as it relates to revenue cycle   Bonus Points for: Knowledge of physical therapy billing practices Experience in digital health Experience in B2B2C healthcare Experience with clearinghouse integrations or APIs with external partners   Benefits: Competitive salary with generous annual cash bonus Stock options Remote first work from home culture Flexible vacation to help you rest, recharge, and connect with loved ones Generous parental leave Health, dental, and vision insurance (and above market employer contributions) 401k retirement savings plan Work from Home stipend Two giftable Omada enrollments per calendar year ...and more! It takes a village to change health care. As we build together toward our mission, we strive to embody the following values in our day-to-day work. We hope these hold meaning for you as well as you consider Omada! Start with Trust. We listen closely and we operate with kindness. We provide respectful and candid feedback to each other. Seek Context. We ask to understand and we build connections. We do our research up front to move faster down the road. Act Boldly. We innovate daily to solve problems, improve processes, and find new opportunities for our members and customers. Deliver Results. We reward impact above output. We set a high bar, we’re not afraid to fail, and we take pride in our work. Succeed Together. We prioritize Omada’s progress above team or individual. We have fun as we get stuff done, and we celebrate together.  Remember Why We’re Here. We push through the challenges of changing health care because we know the destination is worth it. About Omada Health:   Omada is a virtual-first chronic care provider that nurtures lifelong health, one day at a time. Our care teams implement clinically-validated behavior change protocols for individuals with prediabetes, diabetes, hypertension, and musculoskeletal issues for consistent improvements that stack up.  With more than a decade of experience and data, and 24 peer-reviewed publications that showcase our clinical and economic results, we improve health outcomes and help contain healthcare costs.  Our scope exceeds 1,800 customers, including health plans, health systems, and employers ranging in size from small businesses to Fortune 500s. Omada is the first virtual provider to join the Institute for Healthcare Improvement’s Leadership Alliance, reflecting our aim to complement primary care providers for the benefit of our members, and affirming our guarantee to every partner: Omada works different. We carefully hire the best talent we can find, which means actively seeking diversity of beliefs, backgrounds, education, and ways of thinking. We strive to build an inclusive culture where differences are celebrated and leveraged to inform better design and business decisions. Omada is proud to be an equal opportunity workplace and affirmative action employer. We are committed to equal opportunity regardless of race, color, religion, sex, gender identity, national origin, ancestry, citizenship, age, physical or mental disability, legally protected medical condition, family care status, military or veteran status, marital status, domestic partner status, sexual orientation, or any other basis protected by local, state, or federal laws. Please click here for more information on our Candidate Privacy Notice.