Foundation Medicine · 3 hours ago
Director, Reimbursement Operations
Boston, MA
Full-time
Hybrid
Director/Executive
$166K/yr - $207K/yr
10+ years expFoundation Medicine is focused on enhancing operational health and service excellence. The Director of Reimbursement Operations will lead initiatives to improve revenue cycle operations and manage partnerships with third-party vendors to optimize performance.
BiotechnologyGeneticsHealth CareMedical
Responsibilities
Manage partnership with third-party vendor to maintain a high-performing revenue cycle team
Collaborate across the Revenue & Access and vendor leadership teams to identify opportunities that impact revenue cycle performance
Manage and oversee the activities supporting the full revenue cycle:
Commercial Health Plan Credentialing
Medicare Provider Credentialing
Medicaid claims and payment enrollment at vendor
Contract review (redline), set up and communication to vendor
Annual PAMA submission
Payer analytics
Reimbursement and outcomes
ROI activity
Model billing fees/annual and long-range planning
Invoice review and approval
Quarterly write-offs – analysis oversight and approval
Participate in team huddles
Special projects
Develop, implement, and manage metrics to measure and enhance performance
Support field teams with customer meetings
Analyze financial data to identify trends and areas of improvement in the reimbursement process
Management and development of direct report(s)
Other duties as periodically assigned
Qualification
Required
Bachelor's degree in Healthcare Information or related fields, or equivalent work experience
10+ years of professional work experience
5+ years managerial experience
5+ years of experience in healthcare and medical billing
Extensive experience with pivot tables to aggregate and analyze large financial datasets, identifying key trends and insights. Proficient in creating financial models, charts, and visualizations to inform critical financial decisions; highlight expertise in structuring complex spreadsheets for clarity
Preferred
Master's or other Advanced Degree
Experience working within deadline and resource constraints
Prior experience working with intercultural teams
Demonstrated ability to lead an existing team of employees at different levels of their career
Ability to guide individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
Ability to prioritize as necessary in a fast-paced environment
Ability to work well under pressure while maintaining a professional demeanor
Analytical thinking and solutioning skills
Effective and clear communication and presentation skills
Strong inter-personal skills with the ability to work cross-functionally to accomplish objectives
Willingness to adapt and work in ambiguous and/or changing conditions
Understanding of HIPAA and importance of privacy of patient data
Commitment to reflect Foundation Medicine's values: Integrity, Courage, Passion
Benefits
A discretionary annual bonus may be available based on individual and Company performance.
This position also qualifies for Foundation Medicine's benefits.
Company
Foundation Medicine
Foundation medicine is a molecular information company developing clinical diagnostic tests that facilitates personalized cancer therapies.
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
$96.5MKey Investors
Kleiner Perkins
2015-01-12Acquired
2013-09-25IPO
2013-01-08Series B· $13.5M
Leadership Team
Daniel Malarek
Chief Executive Officer
David Fabrizio
VP, Commercial Strategy and Medical Innovation
Recent News
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