Business Process Consultant

Business Process ConsultantAt Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a Business Process Consultant who will embrace our mission of Advancing Health Together.The Business Process Consultant (BPC) serves as the primary analytical resource supporting all revenue cycle processes, systems and workflow. The BPC is a subject matter expert in Epic (Maestro Care), data analytics, payer reimbursement and demonstrates a broad spectrum of operational expertise across many areas of the Revenue Cycle. The BPC supports the Revenue Cycle departments and operational leaders within the Patient Revenue Management Organization (PRMO) by identifying opportunities to improve operational efficiency and performance. The BPC has a system focus through monitoring of dashboards and key metrics to pro-actively identify, analyze, and trend issues. The BPC strategically supports operations by identifying opportunities to improve workflow and effectiveness through projects and innovative solutions to enhance automation, quality and efficiency through enhancement requests, report writing, analysis and business case development and data validation.Work PerformedIdentification and Analysis of Financial Opportunities:Identify existing and future revenue cycle-based improvement opportunitiesLead PRMO discussions, evaluations, selections and prioritization of improvement opportunities, including the development of an ROI analysis to better understand and determine potential impact on overall PRMO performanceWork closely with PRMO leadership to understand operational goals and challenges to identify opportunities for enhancementsPerform and prepare regular root cause analysis of performance of the revenue cycle function to identify areas of opportunity utilizing various data systems including Slicer Dicer and TableauResponsible for various standard, recurring reporting functions to support revenue cycle operational business needsAssists revenue cycle senior leaders in working closely with organizational stakeholders to improve financial performance based on analytic findingsMonitor key performance indicators for internal and external partiesCultivate internal relationships to assist in understanding department workflowsProvides analytics for and supports special projects as needed (e.g. new payer policy financial impact)Support investigation into claims/denials patterns, payer policy changes, collection rate shifts, avoidable write-off's, and payer mix evaluation to optimize payer performance.Develop analytical models that are well-documented containing advanced formulas and functions that are used to evaluate historical trends, forecast future expectations, or draw conclusionsPoint person for month-end Revenue Cycle Net Revenue ReviewRevenue Cycle Strategic Initiatives and Project Management:Create, design, lead, and implement strategies that will reduce AR, improve aging AR, improve net collection rate, eliminate waste through automation or optimization of workflows, reduce denials, and reduce avoidable write-offs, for all areas of the Revenue CycleDevelop, maintain, and enhance knowledge of Revenue Cycle systems and third-party vendors to support recommendations for optimal workflows.Leverage technology and best practices to recommend process improvementsCollaboration:Effectively communicate trends to influence all levels of leadership for process improvementsPartner with leaders and teams to review and establish improvement opportunitiesPerform project management duties to align multi-disciplinary groups across the revenue cycle and clinical departments, corporate finance, DHTS, and hospital service line leadershipCommunicate and track progress of identified issues and action itemsPartner with Operations Improvement on outstanding optimization and automation projectsOther:Promote PRMO strategic vision, mission, and purpose while emphasizing teamwork and results.Create and foster a department culture that provides a satisfying and enriching environment in which staff can be developed and retained.Interact with and provide timely verbal/written responses to all stakeholders (patients, providers, payors, and departmental personnel).Acknowledge management requests and emails in a professional, timely manner.Attend meetings and participate in Work Culture initiatives, committees or workgroups, as assigned.Accomplish all tasks as assigned.Minimum QualificationsEducation: Bachelor's degree required. Master's degree preferred.Experience: Minimum of 7 years work experience. Extensive knowledge of Revenue Cycle analytical tools, business intelligence tools and statistical packages. Proven experience with Revenue Cycle workflows to include but not limited to overall claims processing spanning the life cycle of the revenue cycle, denials management, insurance follow up, and net collection rate impacts and calculations. Experience can be supplemented with Master's degree with a Masters being equivalent to two years of experience.Degrees, Licensures, Certifications: NoneKnowledge, Skills and AbilitiesKnowledge of:Epic System (Revenue Cycle Applications)Revenue Cycle operationsAbility to:Understand revenue cycle operational performance goals/metricsStrong analytical skillsPerform root cause analysis with accuracyIdentify and implement optimization opportunities within EpicInvestigate and analyze information and provide recommend solutions for identified issuesDevelop, implement and oversee project teams comprised of IT and operational resourcesCommunicate effectively, both orally and in writingDemonstrate strong interpersonal and communication skillsWork effectively with a wide range of constituencies in a diverse communityFoster a positive work environmentMulti-taskSystems:EpicMS Office Applications (Word, Excel, Visio, PowerPoint)Kodiak RCA