DescriptionDescription - ExternalJoin the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today. Position SummaryThe Program Manager will lead the strategic development and implementation of key initiatives supporting Oncology Care Coordination. This role provides program-level oversight of processes related to the review and auditing of documentation, charges, claims, and denials across services such as Principal Illness Navigation, Chronic Care Management, Health Assessments, Social Determinants of Health, and Advance Care Planning.You will design standardized workflows, establish performance metrics, and drive system-wide tracking and reporting to ensure accurate and comprehensive revenue capture. This highly collaborative role partners across clinical, operational, IT, and revenue cycle teams to optimize documentation, billing, and program effectiveness while aligning with organizational priorities.As a successful candidate, you will:Lead the strategic development, implementation, and continuous improvement of documentation, billing, and audit processesAnalyze denials and reimbursement trends to identify payor patterns and optimization opportunitiesDesign and implement standardized workflows to ensure consistent and accurate revenue captureEstablish and monitor key performance metrics to drive program success and improvementsIdentify gaps in documentation, billing processes, or EMR functionality and lead enhancementsDevelop tools, training materials, and resources to improve documentation quality and billing accuracyBuild strong cross-functional relationships to advance Oncology Care Coordination initiativesRepresent revenue optimization efforts in system-wide committees and planning forumsLead project management efforts, ensuring timelines, milestones, and deliverables are achievedOversee implementation of new processes and evaluate outcomes against strategic goalsQualificationsYour qualifications should include: Bachelor’s Degree in Business, Healthcare Administration, or other relevant area of study; 3 additional years of experience plus the minimum experience requirement may substitute for minimum education.Minimum of five (5) years of experience in the healthcare industryAt least three (3) years of experience in professional billingStrong knowledge of coding systems including CPT-4, HCPCS, and ICD-10AAPC and/or CPC certification preferredDemonstrated ability to lead cross-functional initiatives and drive process improvementsCity of Hope employees pay is based on the following criteria: work experience, qualifications, and work location.City of Hope is an equal opportunity employer.To learn more about our Comprehensive Benefits, pleaseCLICK HERE.Job Field: Billing & CodingShift: Days
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