Manager, Professional Billing and Claims

Location: Boston, HybridOrganization Summary:Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.Job Summary:Community Technology Cooperative (CTC), a subsidiary organization of C3 is seeking a highly motivated Manager to lead our Epic systems application teams for professional billing and claims applications for our existing customers and upcoming implementations. The Manager of Professional Billing and Claims will be housed under a subsidiary organization of C3, Community Technology Cooperative, LLC (CTC) and reports to the Senior Director of Applications. The Epic applications for the Manager role include Epic’s Professional Billing, Claims, Benefits Engine, Reimbursement Contracts and SBO (Single Billing Office) applications in addition to third-party applications. The Manager monitors and advises on various aspects of their respective applications including internal collaboration with colleagues as well as external stakeholders.ResponsibilitiesWorkflow development, design, and testing for Epic applicationsGuide workflow design, building, and testing the system, and analyzing other technical issues associated with Epic softwarePartner with Epic representatives, the health centers’ business community, and end users to ensure the system meets their business needs regarding the project deliverables and timelineEngage with appropriate leadership regularly to review the status of projects and issuesProblem-solve concerns and escalate issues to appropriate members of the leadership teamWork collaboratively with the leadership team of CTC and C3 towards the strategic goals of C3, CTC and the health centers that we serveDevelop an understanding of operational needs to collaborate and set the direction for the organization's workflowsAssist with the identification, evaluation, and assessment of new technology, developing recommendations on the impact of integration with existing workflows and systemsAbility to manage and prioritize initiatives with competing prioritiesDemonstrate a proactive mindset with the ability to analyze and anticipate possible events priorAnswer questions and foster enthusiasm for HIT projects within the health centersMaintain the scope, schedule, and quality of the project in their specific application areas and/or teamSet clear expectations for team members, including defining what they should do at each phase of the projectWork closely with the program manager and other project managers to coordinate activitiesEnsure that the health center community is informed and engaged with all aspects of the implementations and workflowAdvise and coach team members by providing guidance on project issues, key success factors of the project, and lessons learnedDevelop and mentor team to build a culture of excellence, collaboration and great customer serviceIdentify and document implementation issues and best practices to create a process for future implementationsShare the positive effects of innovation and system capabilities with team membersReinforce the importance of the project together with the executives and the project manager, and providing consistent communication to the project teamAppropriately matching team member skills to team responsibilitiesManage the project from an organizational perspective while attending to detailed tasksWork directly with third-party vendor contacts for escalations and participating in monthly or quarterly check-insMaintain contracts with third party vendors, including but not limited to monitoring volumes for overage costs, reporting of total visits and users for annual renewalsManage upgrades, maintenance and implementation of new features for third-party vendorsOther duties as assignedRequired Skills:5+ years Epic experience in the areas of professional billing, SBO and/or claims applications in an Epic IT departmentCertification in Professional Billing with Single Business Office (SBO)Knowledge of the overall revenue cycle from the front end to back-end billingKnowledge of financial reportingExperience tracking financial metrics and revenue cycle activities for Epic go livesAbility to provide direction and oversight for simultaneous core organization projectsExperience with a minimum of two Epic implementations requiredProven record of accomplishment of EMR implementation and optimization of systemsDesired Other Skills:Prior experience with FQHCs is strongly preferredFamiliarity with the MassHealth ACO programsExperience with anti-racism activities, and/or lived experience with racism is highly preferredQualifications:Bachelor's degree** In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **