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Job Title: Senior Associate Revenue Cycle – Mount Sinai Health Partners

Background

Mount Sinai is one of the largest U.S. health systems with a strong reputation for quality of care (top 20 ranked US academic medical center) and innovative research/education (top 20 ranked US medical school, >$400M annually in NIH-funded research). This reputation is important but it’s not enough. At Mount Sinai, we have a responsibility to make healthcare better, optimizing its value for patients, purchasers, and communities.

The health care industry has a number of problems; there is an affordability crisis as federal and state governments are unable to keep Medicare & Medicaid solvent, employers are stretched to pay for health benefits for their employees, and those employees struggle to afford increasing paycheck deductions and deductibles. In addition, the industry has historically set a low bar for customer service, earning some of the lowest satisfaction scores of any industry, eroding trust from stakeholders. In recent years, employers and labor unions have begun to solve these problems by contracting directly with select providers and health systems, as well as vendors, to optimize value.

Mount Sinai Solutions was created to collaborate directly with purchasers to solve these problems. We have assembled Mount Sinai's clinical and population health assets into product offerings of high-quality care that are affordable and distinguish themselves via exceptional service. Our offerings include next-generation primary care at or near the workplace (“Health Centers”), centers of excellence for specialty care, and high-performance network (HPN) based health benefit plans, in partnership with health plans. Our team markets & sells these products directly to the purchaser – i.e., consumers, large employers, labor unions. We are looking for people to join our team who are passionate about solving these problems by developing a true system of care that can deliver market-leading value.

Role Summary

There is a $750 million and growing addressable market opportunity in the New York City metro area from large employers and labor unions that contract directly with “high value” providers for “true primary care” that includes navigation, immediate care, preventive care, and tech-enabled programs to improve health and manage chronic illness, as well as “centers of excellence” for specialty care focused on common surgeries and chronic conditions.

Large employers (e.g. Walmart) and large labor unions (e.g. SEIU Local 32BJ) are shifting from purchasing exclusively through health plans to direct contracts with these “high value” providers, changing benefits plans to incent their employees to consume more from them. Almost 60% of large employers have purchased some form of primary care directly from providers and many labor unions (that make up 20% of the NYC commercial market) have followed suit. Competition for these direct contracts is intense from health systems and specialty hospitals (e.g. Northwell, NYU, Memorial Sloan Kettering, HSS) as well as well-capitalized vendors (e.g. Signify Health, Carrum Health, Transcarent in the specialty care COE space and Premise Health and OneMedical in the primary care space).

Mount Sinai entered this space in 2016; since then, we have grown significantly and established a reputation as a market-leader in this space. In the direct primary care space we have added 15 large employer and union customers, 55,000 eligible members, >$20 million in annual revenue, 5 cities, and multiple additions to our product portfolio. In the COE space, we have grown our customers, products, and markets (now available in 6 markets in addition to NYC). Our customers have enjoyed market-leading value, saving millions while improving health care outcomes and service (consistent 90+ member NPS). We have also launched new products focused on advisory services for employers and unions, initially to effectively guide their members through Covid and increasingly to strategize on how best to improve the overall healthcare experience and value for employees and members.

The Senior Associate, Commercialization Revenue Cycle Operations is accountable to help lead aspects of facility and professional revenue cycle operations to support the full Mount Sinai Solutions product portfolio. The Senior Associate will report to the Lead of Commercialization Revenue Cycle Operations and will work collaboratively with the health centers to achieve this goal. In their role, The Senior Associate will collaborate with MSHS professional, ancillary, and facility revenue cycle teams to serve as the single point of contact to address any commercialization revenue cycle need across all areas of the health system. In addition, the Senior Associate will collaborate with 10s of other leaders throughout the Mount Sinai Solutions business as well as leadership from across the Mount Sinai Health System, health system partners in other cities, and the TPAs of customers.

Responsibilities

Provide Billing Support to new and existing health centers – The Senior Associate will support the commercialization team throughout the customers lifecycle (marketing, sales, implementation) to ensure products meet customer revenue cycle needs and are feasible for MSHS to implement – highlights:

• Acts as liaison with all levels of administration in the coordination of operational activities to achieve directives and facilitate problem resolution
• Develops and oversees business systems and works with Information Technology to ensure timely and accurate implementation
• Monitors daily operating activities of assigned department and makes suggestions necessary for improved workflow and efficiency
• Attends administrative meetings and participates in committees as requested. Conducts special projects and studies, as directed
• Communicates daily with front-end staff to inform them of missing information necessary for work queue release
• Ensures that providers are properly credentialed with hospital and insurance companies in a timely fashion to ensure timely billing
• Works closely with Lead of Revenue Cycle Operations and recommends new processes to improve workflow and efficiency
• Assists in the planning of short and long-range goals for the department, unit or division. Prepares and evaluates proposals to implement new programs and expand existing ones
• Creates and maintains Dashboards in Excel and Tableau for tracking and reporting purposes
• Creates and prepares/updates monthly and ad hoc Power Point presentations and presents to leadership during high level meetings

Enforce Governance Process to Ensure Revenue Cycle Outcomes Exceed Customer Expectations – The Senior Associate will drive a governance process for revenue cycle operations to ensure customer needs are met - highlights:

• Develops and implements new procedures to improve the quality and quantity of work processed. Ensure policies are communicated and administered consistently
• Prepares operational and financial reports and analysis, noting progress as well as adverse trends. Makes appropriate recommendations or conclusions. Maintains required records and files.
• Plans and directs patient registration, billing flags, insurance and other necessary data is properly captured to ensure accurate billing to insurance and patients for efficient account collection.
• Coordinates the release of work queues and ensures that all pertinent and necessary information has been captured by the front-end
• Communicates daily with front-end staff to inform them of missing information necessary for work queue release
• Continually evaluate revenue cycle operations to find new opportunities to improve productivity, reduce operating expenses, and enhance customer service

Qualifications

Education

• Bachelor’s Degree required; MBA preferred

Professional Experience

• Minimum of 5 years of experience in healthcare billing operations (ideally for a large health system)
• 2+ years of leadership experience with decision-making authority
• Experience leading a consumer-facing operation to deliver exceptional service (measured via NPS)

Other Qualities

• Highly organized, structured, and detail-oriented in approach to leading teams and stakeholders
• Innovative thinker who can develop solutions where there are few precedents; comfortable with ambiguity
• Exceptional people leader who knows how to get the best out of individuals and teams
• Resilient approach that doesn’t dwell on setbacks, finding creative solutions to obstacles

Who We Are

Over 42,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.

Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospitals, including Mount Sinai Beth Israel, Mount Sinai Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.

The Mount Sinai Health System (MSHS) provides equal employment opportunity to all its employees and applicants for employment without unlawful discrimination on the basis of their actual or perceived race, creed, color, religion, national origin, sex, gender, gender expression, gender identity, age, disability, marital or parental status, sexual orientation, veteran, immigration, citizenship, or other protected status.

EOE including Veterans and Disable

Compensation

The Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $106,108.00 - $159,161.00 Annually. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.