Process Improvement Manager - Centralized Risk Adjustment & RCM (Hybrid)

Homeward Health Austin , TX 78719

Posted 2 weeks ago

Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.

Our vision is care that enables everyone to achieve their best health. So, we're creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality. Homeward supports Medicare-eligible beneficiaries by partnering with health plans, providers, and communities to align incentives - taking full financial accountability for clinical outcomes and the total cost of care across rural counties.

As a public benefit corporation and Certified B Corp, Homeward's mission and business model are aligned to address the healthcare, economic, and demographic challenges that make it challenging for rural Americans to stay healthy. Our Homeward Navigation platform uses advanced analytics to connect members to the right care and local resources that address social determinants of health and improve holistic health outcomes. Since many rural communities lack adequate clinical capacity, Homeward also employs care teams that supplement local practices and reach people who cannot otherwise access care.

Homeward is co-founded by a leadership team that defined and delivered Livongo's products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.

The Opportunity

We are looking for a dedicated and dynamic Process Improvement Manager-Risk Adjustment & RCM to join our team. This role's primary focus is to enhance operational efficiencies and refine processes to achieve our strategic objectives and deliver outstanding results across the organization, with both internal operations and client interactions.

In this key position, you will collaborate with various stakeholders, such as the Director of Risk Adjustment and RCM, Market Directors, Market Practice Managers, Data and actuarial, Product, and IT, to design and implement innovative process improvement initiatives. Your role is crucial in developing scalable, sustainable, and standardized processes that support the growth and efficiency of our operations.

The ideal candidate must possess strong organizational and technical skills, meticulous attention to detail, and the ability to effectively manage multiple priorities and deadlines. You should also bring creative problem-solving skills to tackle unique challenges. This position requires a proactive leader who is adept at navigating evolving organizational structures and driving substantial improvements in healthcare delivery, particularly in the challenging environment of rural healthcare.

What You'll Do:

  • Design and implement process improvements and best practice methodologies within the Risk Adjustment and RCM domains.

  • Collaborate with cross-functional teams to analyze existing processes, identify bottlenecks, and recommend solutions to enhance productivity, effectiveness, and scalability.

  • Engage and influence internal and external stakeholders as participants and owners of the processes being improved.

  • Monitor and report on the impact of implemented improvements, adjusting strategies as necessary to meet evolving business needs.

  • Stay abreast of regulatory changes and industry trends to ensure compliance and maintain competitive advantage.

  • Facilitate training sessions and workshops to drive continuous learning and improvement within the team and organizational-wide.

  • Collaborate with a team of Risk Adjustment & RCM specialists in executing process enhancement initiatives.

What You Bring:

  • Bachelor's degree in Business Administration, Healthcare Administration, or a related field. Advanced degree preferred.

  • Minimum of 5 years experience in process improvement, focusing on Medicare risk adjustment and revenue cycle management in a provider organization.

  • Proven track record of leading successful process improvement projects involving multiple organizational stakeholders with measurable results.

  • Strong analytical skills and proficiency in using process mapping and analysis tools.

  • Excellent leadership, communication, and interpersonal skills.

Impress us Even More:

  • Certification in Lean, Six Sigma, or a related discipline.

  • Experience with clinical documentation improvement.

  • Experience with telehealth and remote patient monitoring.

  • Creative thinking and the ability to thrive in a dynamic, fast-paced environment.

What Shapes Homeward:

  • Deep commitment to one another, the people and communities we serve, and to provide care that enables everyone to achieve their best health

  • Compassion and empathy

  • Curiosity and an eagerness to listen

  • Drive to deliver high-quality experiences, clinical care, and cost-effectiveness

  • Strong focus on the sustainability of our business and scalability of our services to maximize our reach and impact

  • Nurturing a diverse workforce with a wide range of backgrounds, experiences, and points of view

  • Taking our mission and business seriously, but not taking ourselves too seriously- having fun as we build!

Benefits:

  • Competitive salary and equity grant

  • Unlimited Paid Time Off

  • Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees

  • Company-sponsored 401k plan

At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.

Homeward is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.


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Process Improvement Manager - Centralized Risk Adjustment & RCM (Hybrid)

Homeward Health