Veracyte
healthcare
Sr.Manager,ReimbursementOperations–StrategicInitiatives
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“Sr. Manager, Reimbursement Operations – Strategic Initiatives at Veracyte. Skills: process management, cross-functional coordination, vendor/stakeholder management, operational metrics, resource planning, continuous improvement, healthcare reimbursement, revenue cycle operations. lead high-impact initiatives within the Revenue Cycle Operations. designing and implementing processes to achieve sustainable operational improvements”
What You'll Achieve.
achieve sustainable operational improvements; drive incremental collections; Reduce denials; increase Claim Overturns by improving appeal efficacy; ensure the success of key workstreams part of reimbursement operations; optimize the revenue cycle process; optimize reimbursement
Industry & Context.
Advanced analytical skills with the ability to translate complex data into actionable insights; performing root causes analyses on claims performance issues, identifying ways to solve those issues
What They're Looking For.
Must Have
8+ years of experience in healthcare reimbursement, revenue cycle operations, or related financial operations, with progressive leadership responsibility, Success in building and lead Revenue Cycle operational teams across various fuctions, Demonstrated success driving process improvement and reimbursement optimization initiatives with measurable financial impact, understanding of payor dynamics, prior authorization, claims adjudication, denials, and appeals, with experience participating in conversations with payors on claims or other related issues to achieve resolution, Experience leading or partnering with automation, AI, or technology enabled operational transformations, Advanced analytical skills with the ability to translate complex data into actionable insights, Proven ability to lead cross functional initiatives in a fast paced, ambiguous environment
Nice to Have
CPMA/CPC Certifications, Clinical Background (BSN, Genetic Counseling), Experience in diagnostics, laboratory services, or complex reimbursement environments, Formal training or certification in Lean, Six Sigma, or process improvement methodologies
What You'll Do.
lead high-impact initiatives within the Revenue Cycle Operations, designing and implementing processes to achieve sustainable operational improvements, drive incremental collections (Reduce denials, increase Claim Overturns by improving appeal efficacy, et al), ensure the success of key workstreams part of reimbursement operations (e.
, Digital System Transformations, Epic Interoperability, et al), Develop and implement strategic plans to optimize the revenue cycle process, aligning it with organizational goals and industry best practices, Design and deliver scalable, system-based solutions by producing clear problem statements, process maps, business requirements, et al to facilitate the implementation of new processes or technologies, Support the optimization of collections by performing root causes analyses on claims performance issues, identifying ways to solve those issues, and partnering with relevant teams to implement and drive to resolution, Take a proactive role in evaluating and implementing revenue cycle technologies (OCR, AI-Enabled workflows, integrations, automations, et al.
) to enhance operational effectiveness, Leverage expertise in Clinical Coding and Documentation to ensure operational systems/processes are built to reduce risk of erroneous billing and optimize reimbursement, Serve as Project Lead on Strategic Revenue Cycle Initiatives (technology or other) to ensure the successful implementation and operationalization is achieved, Partner with Reimbursement leaders to re‑engineer reimbursement workflow to standardize processes while preserving flexibility for payor‑specific nuances.
How You'll Work.
Team & Collaboration
partnering with relevant teams to implement and drive to resolution; Partner with Reimbursement leaders to re‑engineer reimbursement workflow
Communication Scope
interpersonal; communication skills will be critical to success
Process & Methodology
Serve as Project Lead on Strategic Revenue Cycle Initiatives
Full Job Description
At Veracyte, we offer exciting career opportunities for those interested in joining a pioneering team that is committed to transforming cancer care for patients across the globe. Working at Veracyte enables our employees to not only make a meaningful impact on the lives of patients, but to also learn and grow within a purpose driven environment. This is what we call the Veracyte way – it’s about how we work together, guided by our values, to give clinicians the insights they need to help patients make life-changing decisions. Our Values: We Seek A Better Way: We pursue bold ideas, embrace complexity, and keep pushing forward. We Make It Happen: We act with urgency, deliver with excellence, and always find a way. We Are Stronger Together: We engage with empathy, align around what's best for Veracyte, and celebrate as one team. We Care Deeply: We show up with integrity, kindness, and respect for one another. The Position: We are seeking a highly skilled and experienced Senior Manager, Reimbursement Operations – Strategic Initiatives to lead high-impact initiatives within the Revenue Cycle Operations. This role will be focused on designing and implementing processes to achieve sustainable operational improvements, drive incremental collections (Reduce denials, increase Claim Overturns by improving appeal efficacy, et al), and ensure the success of key workstreams part of reimbursement operations (e.g., Digital System Transformations, Epic Interoperability, et al). Success in this role requires deep expertise in medical billing systems, fluency in payor medical strong analytical, interpersonal, and communication skills will be critical to success as well. Develop and implement strategic plans to optimize the revenue cycle process, aligning it with organizational goals and industry best practices. Design and deliver scalable, system-based solutions by producing clear problem statements, process maps, business requirements, et al to facilitate the implementation of new pr
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