Senior Denial Prevention Process Improvement Advisor
Ensemble Health Partners
Base: $69,000.00 to $104,100.00; bonus/equity: bon...
Fully remote
Deep dive analysis on clinical and technical denials
Root cause analysis using sql and epic bdc
Process improvement expertise for denial remediation
The role involves leading deep dive analysis on clinical and technical denials to identify patterns and trends across large volumes of data
Job Summary
The role involves leading deep dive analysis on clinical and technical denials to identify patterns and trends across large volumes of data.
Candidates will utilize advanced analytics tools including parsed 835 data, Epic BDC records, and SQL to perform root cause analysis.
Ensemble offers comprehensive benefits, tuition reimbursement, paid certifications, and a culture focused on empowering employees to challenge the status quo.
Matching Summary
The role involves leading deep dive analysis on clinical and technical denials to identify patterns and trends across large volumes of data.
Salary
Base: $69,000.00 to $104,100.00; Bonus/Equity: Bonus Incentives included; Benefits: Comprehensive benefits package including healthcare, time off, retirement, and well-being programs
Skills & Requirements
Must-have
Deep dive analysis on clinical and technical denials
Root cause analysis using SQL and Epic BDC
Process improvement expertise for denial remediation
Client-facing stakeholder management skills
Advanced usage of AI in process improvements
Nice-to-have
Strong persuasion skills to influence SMEs
Experience with Lean Six Sigma methodologies
Ability to foster culture of creativity
Strategic advisory perspective on quality
Collaborative team-oriented mindset
Key Requirements
Bachelor's degree in Healthcare administration or Business
Intermediate Excel and Access skills
Project management and data analytics experience
Certified Specialist Managed Care (CSMC) preferred
LEAN Six Sigma Black Belt certification preferred
Willingness to travel onsite as business needs require