Medicaid Revenue Manager

Medicaid Revenue ManagerThe Medicaid Revenue Manager is responsible for overseeing Medicaid revenue-cycle activities across the company's Senior Living's multi-state portfolio of Medicaid-participating communities. The role serves as a central point of coordination among communities, third-party billing resources, state Medicaid agencies, managed care organizations, and internal finance and operations teams.This position is responsible for helping ensure Medicaid services are appropriately enrolled, billed, collected, and reported; identifying and resolving rejected or delayed claims and aging accounts receivable; and managing Medicaid enrollment, credentialing, licensing, and change-of-ownership requirements.As a newly created position, the Medicaid Revenue Manager will also develop processes, reporting, and operating practices to improve consistency and visibility across the organization.Key ResponsibilitiesOversee Medicaid revenue-cycle activity across approximately 70 communities operating in multiple states.Monitor Medicaid billing, collections, aging accounts receivable, rejected claims, and other revenue-cycle issues.Investigate Medicaid claims that are rejected, delayed, underpaid, or unpaid and coordinate appropriate resolution.Identify recurring billing and collection issues and recommend corrective action.Review financial and operational reports to identify revenue risks, trends, and areas requiring intervention.Partner with community and corporate leadership to address Medicaid-related financial pain points.Serve as a primary point of coordination with the third-party vendor responsible for Medicaid billing submissions.Monitor billing activity and follow up on unresolved claims, discrepancies, and outstanding balances.Ensure required information is provided by communities and other internal resources so claims can be processed accurately and timely.Escalate recurring or significant vendor, payer, or process issues as appropriate.Coordinate Medicaid enrollment and credentialing requirements with state agencies and managed care organizations.Manage documentation required to establish or maintain Medicaid participation under applicable community licenses.Coordinate Medicaid requirements associated with changes of ownership, licensing changes, and other organizational changes.Maintain accurate enrollment, credentialing, licensing, and payer documentation.Track outstanding applications, renewals, approvals, and other required submissions.Stay current on relevant state Medicaid and managed care requirements affecting assigned communities.Work directly with community leadership and business-office resources to resolve Medicaid billing, documentation, enrollment, and collection issues.Coordinate with finance, operations, licensing, and other internal teams as necessary.Communicate Medicaid requirements and process changes to appropriate stakeholders.Provide leadership with visibility into unresolved issues, aging balances, revenue risks, and operational trends.Develop standardized processes for managing Medicaid revenue-cycle, enrollment, credentialing, and reporting activities across the portfolio.Establish tracking mechanisms and reporting that provide visibility into claims, collections, credentialing status, and outstanding issues.Identify opportunities to improve efficiency, accountability, and consistency.Build practical processes and procedures for a newly established function with limited existing infrastructure.QualificationsDemonstrated experience working with Medicaid billing, revenue cycle, payer enrollment, credentialing, accounts receivable, or related Medicaid financial operations.Working knowledge of Medicaid processes and requirements; multi-state Medicaid experience strongly preferred.Experience interacting with state Medicaid agencies and/or Medicaid managed care organizations preferred.Experience investigating denied, rejected, delayed, or unpaid Medicaid claims.Ability to interpret aging reports and other financial or operational reporting.Experience with Medicaid enrollment, licensing, credentialing, or change-of-ownership processes is highly desirable.Healthcare experience required; experience may come from senior living, behavioral health, home health, hospice, post-acute care, or another Medicaid-intensive healthcare environment.Associate or bachelor's degree in healthcare administration, finance, business, human services, or a related discipline preferred; equivalent relevant experience will be considered.Critical CompetenciesStrong understanding of Medicaid revenue-cycle processesFinancial and analytical capabilityProblem-solving and follow-throughProcess-development mindsetAbility to work independently with limited existing structureStrong organizational skills and attention to detailAbility to manage multiple states, communities, payers, and priorities simultaneouslyEffective communication with community, corporate, vendor, payer, and governmental stakeholdersSelf-direction and accountabilityPosition CharacteristicsNewly created positionMulti-state responsibilityApproximately 70 Medicaid-participating communitiesRemote work environmentIndividual contributor role with significant cross-functional responsibilityOpportunity to build and standardize the Medicaid revenue-management function Zingaro, Fidler, Wolfe & Co.