The Infusion Operations Lead (Integrations) will be responsible for overseeing the integration of infusion services with a focus in revenue cycle management (RCM) and patient care processes, ensuring seamless workflow optimization, compliance, and efficiency. This role will assist cross functional leaders in managing and executing integration initiatives. The candidate will require a deep understanding of infusion billing, payer regulations, and project management methodologies to drive successful implementations and process improvements. The Infusion Integrations Lead will collaborate cross-functionally with clinical, financial, and operational teams to enhance revenue integrity and streamline integration efforts.
Key Responsibilities:
Support integration of infusion services within the revenue cycle framework, ensuring alignment with payer requirements, coding regulations, and reimbursement policies.
Develop and manage implementation plans for new system integrations, including EHRs, billing platforms, and financial reporting tools.
Work closely with cross-functional teams to assess and optimize workflows, reducing inefficiencies in claim submissions, prior authorizations, and reimbursement processes.
Monitor revenue cycle KPIs and identify areas for process improvements to enhance revenue capture and minimize denials.
Serve as a liaison between IT, finance, and clinical teams to ensure seamless system functionality and interoperability.
Support payer contract implementation, ensuring compliance with reimbursement structures and billing guidelines.
Provide leadership in revenue cycle data analysis, reporting, and performance tracking during integrations process.
Ensure compliance with federal, state, and local regulations, including HIPAA and other healthcare industry standards.
Manage integration-related projects, including timelines, risk mitigation, and stakeholder communications.
Develop training materials and conduct training sessions for staff on system integrations and revenue cycle enhancements.
Qualifications:
· Associate degree or relevant certification (e.g., Certified Revenue Cycle Representative (CRCR); or equivalent relevant experience in RCM, billing, or medical collections
3+ years of experience in revenue cycle management, infusion services, or healthcare operations, with a focus on system integrations.
Strong knowledge of payer policies, reimbursement methodologies, and coding compliance related to infusion services.
Project management experience, including the ability to manage multiple initiatives simultaneously.
Proficiency with EHR, RCM, and billing platforms (e.g., WeInfuse, Athena, Epic)
Demonstrated ability to analyze data, identify trends, and implement process improvements.
Excellent communication, leadership, and problem-solving skills.
PMP, Lean Six Sigma, or other project management certification preferred.
Work Environment & Location:
This position will be remote, with occasional travel required for team meetings, site visits, and training sessions.
Compensation & Benefits:
Competitive salary, performance-based incentives, comprehensive benefits package, and opportunities for professional growth and development.
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