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Adventist Health · 8 hours ago

Manager, Revenue Analytics

Marysville, CA

Full-time

Onsite

Mid, Senior Level

5+ years exp

Adventist Health is a faith-based, nonprofit health system serving communities on the West Coast and Hawaii. The Manager of Revenue Analytics will lead the Revenue Management department operations, focusing on maximizing reimbursement and reducing denials through data-driven insights and collaboration across various departments.

Elder CareHealth CareHospitalMedicalNon ProfitWellness

Responsibilities

Directs the weekly High Dollar Review process across multiple hospitals, coordinating with Patient Access, Case Management, Utilization Management, Billing, Patient Financial Services, and other revenue cycle disciplines to surface systemic gaps and improve reimbursement. Leads denial management strategy, including root cause analysis, denial prevention initiatives, and tracking resolution performance across all payer types

Coordinates with all stakeholders to ensure timely appeal submission and to strengthen payer accountability for overturning inappropriate denials. Monitors denial trends to identify systemic issues and drives corrective action to improve reimbursement outcomes. Identifies and removes barriers to clean claims, timely payment, and full reimbursement

Serves as key liaison between Finance, Payer Relations, Case Management, Utilization Management, and Revenue Cycle to ensure contracts are optimized, compliance maintained, and reimbursement risk mitigated. Collaborates in payer escalation and Joint Operating Committee forums, presenting data-driven cases to secure authorization processes, correct DOFR misalignments, and resolve denials

Oversees contract performance analytics, ensuring payer adjudication aligns with negotiated terms and flagging discrepancies. Reviews Aged Trial Balance (ATB) to identify reimbursement risks by payer behaviors, service line, and internal deficiency trends. Assists the Finance team to prepare and analyze AR Reserve, identifying trends that significantly impact net revenue

Builds, coaches, and mentors a high-performing analytics team that integrates clinical and financial insights to improve net revenue yield. Ensures timely completion of performance reviews, orientation, compliance training, and continuing education for staff. Maintains a supportive work environment through effective selection, orientation, management, and staff development. Interviews, hires, and trains employees in a timely manner

Performs other job-related duties as assigned