Health Care, Revenue Cycle- Pricing Manager

Management Consulting | Core Business Operations
Same job available in 13 locations

Atlanta, Georgia, United States

Boston, Massachusetts, United States

Charlotte, North Carolina, United States

Chicago, Illinois, United States

Dallas, Texas, United States

Houston, Texas, United States

Los Angeles, California, United States

McLean, Virginia, United States

Minneapolis, Minnesota, United States

New York, New York, United States

Philadelphia, Pennsylvania, United States

Pittsburgh, Pennsylvania, United States

Washington, District of Columbia, United States

Position Summary

PRACTICE OVERVIEW

Offering – What we do

Operations Transformation practitioners serve as trusted advisors to our clients, combining strategic thinking with deep industry knowledge to solve complex business problems in a team-based environment. We architect operating models and processes that enable growth, optimize capital, and maximize operational efficiency.

Industry – Who we serve

Deloitte’s Healthcare Consulting practice is one of the largest in the world. Our practice delivers distinctive services to the country’s largest national and regional health plans, 10 of the 10 largest healthcare systems and 8 of the 10 largest for-profit healthcare systems in the US.

YOUR ROLE

Candidate profile

Candidates will be at the intersection of leading business and tech enabled transformation journey’s and improving performance with our clients. Practitioners will have the opportunity to leverage the industry’s leading healthcare innovations and digital transformations to influence the Future of Health. Our healthcare practice seeks to transform the delivery of care, modernize the industry and enhance our clients’ business and operational models. 

The ideal candidate will be curious, analytical, and confident, with a natural drive to exceed immediate project requirements and overcome obstacles. A genuine passion for the healthcare industry, combined with relationship-building, leadership, and communication skills will be critical to success. Candidates should be energized by continuous personal improvement, proactively seeking out new skills and perspectives, exhibiting openness to coaching from senior colleagues, and contributing to the development of junior staff. 

Your role

You will lead and deliver small engagements, or components of large, complex engagements for healthcare clients. Typical engagements include process improvement, operating model design, competitor benchmarking, cost transformation, customer and product innovation, and growth strategy development. Using a combination of direct management and hands-on delivery, you will craft solutions for clients, guide and oversee the quality of your team’s deliverables and recommendations, and manage day-to-day stakeholder relationships. Managers will contribute to Deloitte’s thought leadership, play a significant role in business development activities, and own responsibility for the development of junior staff.

 

Qualifications

  • Bachelor’s degree from accredited university
  • Minimum of 6 years of professional experience in a health care or consulting setting (or at least 4 years with MBA/MHA/equivalent master’s degree)
  • Minimum of 4 years of professional experience in revenue cycle operations, managed care operations or payer/contracting strategy in a health care provider, consulting or technology vendor environment.
  • Demonstrates consistent career progression with increasing levels of responsibility
  • Competent in Microsoft suite of Business Software, specifically Excel and PowerPoint
  • Ability to travel 50% on average, based on the work you do and the clients and industries/sector you serve

Knowledge Base:

  • Knowledge of health care operations, specifically front, middle and back-end Revenue Cycle processes (e.g., Patient Access, Charge Integrity, Coding, Charge Description Master, and Patient Financial Services) and Managed Care processes (e.g., contract negotiations)
  • Understanding of health care revenue cycle data and reporting as it relates to the claims and remit processes
  • Comprehensive knowledge of federal and state laws, regulations and rules affecting institutional healthcare providers, specifically related to Revenue Cycle (e.g., Price Transparency, No Surprises Act)
  • Familiar with overall payor contract structures, including common fee-for-service reimbursement mechanisms (e.g., percent of charge, MSDRG-based, fee schedules, outliers), contract terminology (e.g., rate increase limits), medical policies (e.g., pharmacy white and brownbagging), and risk-based reimbursement structures

Skills:

  • Demonstrated ability to work with large data sets and ability to synthesize, summarize and visualize data in data visualization software (e.g., Tableau)
  • Proficiency and experience with financial, billing and reimbursement data, especially net revenue/scenario modeling analyses of payor reimbursement
  • Competent in Microsoft Office Suite of Business Software, specifically Excel, SQL, and PowerPoint
  • Exceptional written and oral communication skills, including presentation skills with experience presenting to senior levels
  • Demonstrated ability to think critically, using logic and reasoning, and solve problems creatively
  • Demonstrated ability to manage, supervise, train, and coach staff to create an effective and high performing team

In addition, successful Managers will also have the following preferred skills

  • Excellent undergraduate academic record (GPA 3.5+) with preferred degree in accounting or finance
  • Advanced degree in business or health care-related field (e.g., MHA, MBA) from a top-tier program
  • 5+ years health care pricing-related experience and/or 2+ years of management consulting experience in a health care related field
  • Knowledge of the charge development and charging processes, and the interrelationship of cost accounting, cost reporting, and related functions
  • Knowledge and experience with contractual allowances and third-party settlements to ensure financial integrity at the facility level
  • Experience with hospital financial and patient accounting systems, such as EPIC, Cerner, Soarian, SMS, McKesson, Invision, HBOC, MEDITECH, and Eclipsys
  • Possess a working knowledge of the UB-04, and HCFA-1500 claim form and claim scrubber
  • Experience with CMS rules and regulations related to APC/APG reimbursement, coding, billing, and compliance
  • Knowledge of and experience with government and third-party contract reimbursement mechanisms and contract negotiation strategies and tactics
  • Superior critical thinking, analytical and problem-solving skills
  • Ability to build consensus and foster change in a client business setting
  • Tolerance for working in ambiguous, uncertain environments
  • Commitment to personal and professional growth
  • Sense of responsibility to self, team and client
  • Outstanding integrity, initiative, creativity, and passion
  • Experience leading or managing teams

healthcare22

#LI-SF1

Our people and culture

Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. Learn more about our inclusive culture.

Professional development

From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.


As used in this posting, "Deloitte" means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.

Requisition code: 107435

SCAM ALERT

Caution against fraudulent job offers!

We have been informed of instances where jobseekers are led to believe of fictitious job opportunities with Deloitte US (“Deloitte”). In one or more such cases, false promises of actual or potential selection, or initiation or completion of the recruitment formalities appear to have been or are being made. Some jobseekers appear to have been asked to pay money to specified bank accounts of individuals or entities as a condition of their selection for a ‘job’ with Deloitte. These individuals or entities are in no way connected with Deloitte and do not represent or otherwise act on behalf of Deloitte.

We would like to clarify that:

  • At Deloitte, ethics and integrity are fundamental and not negotiable.
  • We are against corruption and neither offer bribes nor accept them, nor induce or permit any other party to make or receive bribes on our behalf.
  • We have not authorized any party or person to collect any money from jobseekers in any form whatsoever for promises of getting jobs in Deloitte.
  • We consider candidates on merit and that we provide an equal opportunity to eligible applicants.
  • No one other than designated Deloitte personnel (e.g., a Deloitte recruiter or Deloitte hiring partner) is permitted to extend any job offer from Deloitte.

Anyone who at any time has made or makes any payment to any party in exchange for promises of job or selection for a job with Deloitte or any matter related to this (including those for ‘registration’, ‘verification’ or ‘security deposit’) or otherwise engages with any such person who has made or makes fraudulent promises or offers, does so (or has done so) entirely at their own risk. Deloitte takes no responsibility or liability for any such unauthorized or fraudulent actions or engagements. We encourage jobseekers to exercise caution.