Life at Healthy Alliance 

At Healthy Alliance, our purpose is to improve health and empower the underserved. Every community has its own needs, affecting the health of those who live, learn, work, and play within them. Our network brings together organizations, big and small, to coordinate and collaborate so that all communities have reliable access to the resources they need. Why? Because every New Yorker deserves the same opportunity to be healthy.  

Designated as the Social Care Network (SCN) Lead Entity for the Capital Region, Central NY, and North Country under New York’s 1115 Waiver Amendment’s SCN & Health-Related Social Needs (HRSN) Program, we are responsible for ensuring that there is a seamless, consistent end-to-end process for HRSN screening, navigation, and the delivery of HRSN and other services to thousands of Medicaid Members. Transformative in nature, this novel Program will further sustain our mission of advancing health equity within and across historically marginalized communities. 

As a 2019-2024 Albany Business Review’s Best Places to Work and a 2021-2024 Modern Healthcare’s Best Places to Work in Health Care award recipient, we strive to maintain a culture wherein high-performing, mission-driven team members collectively work toward better health for all. Dedicated to promoting a culture built upon autonomy, mastery, and purpose, we believe our differences in strengths and perspectives play an integral role in propelling us forward, while our core values ground us, serving as the common thread that unites our team. 

Why You Should Join Healthy Alliance 

We offer amenities, professional development opportunities, events, and programming that support the interests of our teams while expanding and enriching our culture. Some of the benefits you can expect when you join Healthy Alliance include: 

• Competitive compensation package  
• Comprehensive insurance benefits available the 1st of the month after hire, including but not limited to medical, dental and vision, group short-term disability and life insurance with buy-up options, flexible spending and HSA company-contributed accounts, and more 
• 401K with a company match 
• Unlimited paid time off after 90 days of employment 
• Company-sponsored training and certification opportunities 
• Remote employer with flexible work schedules 
• A workplace that values safety, respect, employee engagement, recognition, and diversity 
• Salary range:  $81k-99k per year, commensurate with experience
   

Who You Are 

The Director, Revenue Cycle Management is responsible for the day-to-day management of the Revenue Cycle Management (RCM) billing function and supervision and training of Finance Liaisons and Billing Specialists. This role will ensure the accuracy, reliability, and timeliness of all revenue submissions, collections, reporting, and all information generated by the revenue cycle function. This position works directly with Healthy Alliance network partners as well as internal Finance Liaisons and Billing Specialists to ensure successful implementation and execution of billing requirements for services under New York’s 1115 Waiver Amendment’s Social Care Network (SCN) & Health-Related Social Needs (HRSN) Program. 

What You’ll Do 

• Work in collaboration with and supervise Finance Liaison and Billing Specialist staff in billing Medicaid, Managed Care Organizations (MCOs), and all other related SCN & HRSN Program billing activities. 
• Perform and manage entering, maintaining, and updating all information in internal and external electronic billing database systems regarding community members, service providers, procedures, rates, agency cost center, agency codes, and other relevant information necessary to complete Revenue Cycle Management for Healthy Alliance.  
• Review, manage, and transmit RCM billings.  
• Manage remittance advice and the posting of such in the internal and external electronic billing systems.  
• Assure maximation of cash collections through diligent, timely monitoring of all open accounts’ receivable balances and reviewing cash receipts and EOBs to ensure all charges are being properly billed and paid.  
• Monitor partner SCN & HRSN Program billable claims and assure follow up of denied claims, including but not limited to correction, rebilling, and collection of claims.  
• Assure that all network partners billing practices are compliant with relevant regulations and standards, including federal (e.g. HIPAA), New York State Department of Health (e.g. Medicaid and related Waiver programs, Medicaid Managed Care), and New York State insurance regulations.  
• Manage finance onboarding and training support for Healthy Alliance’s network with the Healthy Alliance training department.  
• Oversee SCN & HRSN Program billable service submissions for timely submission and completeness, following up with the community-based organization’s (CBO) Finance point of contact, MCOs, and Medicaid as needed.  
• Review and cross-check CBO invoices in MillinPro RCM to ensure Finance completes accurate payments in Bill.com.  
• Review and reconcile PMPM payments in MillinPro.  
• Review partner capacity building expense documentation. Review for appropriateness and completeness before they are submitted for payment.  
• Collaborate with internal cross-functional teams to meet partner needs and ensure positive partner experience.   
• Hold weekly check-in meetings with Finance Liaisons, billers, and partners.  
• Identify partner needs and connect to appropriate Healthy Alliance stakeholders.  
• Use Healthy Alliance tools and resources to inform partner communications and meetings.  
• Track and communicate monthly partner financial performance to internal and external stakeholders.  
• Exercise discretion and professional judgement to maintain project-specific timelines and communicate project expectations and timelines with internal and external stakeholders. 

This job description is not designed to cover or contain a comprehensive listing of task activities and/or duties that are required of the employee for this job. Responsibilities and activities may change at any time with or without notice.  

What You’ll Need 

Education 

• Bachelor’s degree in a related field or equivalent experience, such as accounting or business-related fields.

Professional Work Experience 

• Minimum 10+ years of work experience in government/health care payor billing and RCM to include Medicaid and MCOs.  

Skills, Knowledge, and Abilities 

• Excellent written and verbal communication skills.
• Strong working knowledge of Office 365 Suites in addition to moderate technical and analytical skills to compile data for planning and reporting purposes.
• Analytical thinker, able to plan for growth and execute.
• Ability to manage multiple detailed projects simultaneously and adjust as needed.
• Ability to identify the source of a problem and propose a timely solution within budget.
• Strong leadership skills to guide and direct a team.
• Demonstrated commitment to the values of diversity, inclusion, and equity.
• Strong community awareness and astuteness. 
• Embody Healthy Alliance’s vision, mission, and goals. 

Your next career opportunity is at Healthy Alliance!
 

Physical Requirements 

This position involves sedentary work that primarily involves sitting/standing, use of typical office equipment such as a computer, laptop, and cell phone. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Equal Opportunity Employer 

Healthy Alliance is an Equal Opportunity Employer and does not discriminate against any employee or applicant on the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran status, race, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable laws, regulations and ordinances. We adhere to these principles in all aspects of employment, including recruitment, hiring, training, compensation, promotion, benefits, social and recreational programs, and discipline. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to hr@healthyalliance.org. 

Privacy Requirement  

This job function involves potential access/interaction with protected health information. Position will be required to abide by company policies and procedures that support federal, state, and local HIPAA regulations. Any violations will be subject to company policy which includes disciplinary actions up to and including separation of employment.  
 

Healthy Alliance is an At-Will Employer.