We are seeking a highly motivated and experienced Operations Excellence Advisor to join our dynamic team at a 900-location physical therapy company. In this position, you will be instrumental in helping to reshape our strategic initiatives tied to optimal reimbursement. Your responsibilities will include contributing to the creation of comprehensive, clinician-centric processes that provide easy guidelines to our providers about their ability to schedule/treat their patients for care that is covered by their insurance. The ideal candidate for this role will perform, synthesize and document discovery work, oversee & track mini-tests, collaborate with cross functional partners to size ROI, and track revenue results for each key mini-test, pilot, and initiative. Key reimbursement opportunities include but are not limited to: CPT code utilization and optimization, credentialing, authorization, PCP requirements, PTA/OTA modifiers, and cash-based services.
What you bring to be successful:
2+ years in a consultant-type role, preferably in the health care related field and familiar with revenue cycle & payor rules.Experience in referral/prescription intake process innovation and patient adherence/care solution development and implementation.Proficient analytical skills to interpret data, identify trends, and make data-driven decisions. ResponsibilitiesOptimizing Reimbursement Excellence Strategies
• Perform, document, and synthesize ongoing discovery work and feedback loops to support optimal reimbursement strategies
• Track and measure the potential ROI for each strategy to help build the business cases
Mini Test Planning and Implementation
• Support the creation of our mini-testing roadmap leveraging the strategic patient engagement roadmap. This includes creating mini testing/pilot plans and future state rollout plans.
• Track and measure insights. Ensure the metrics and learnings obtained from testing play a crucial role in steering the direction of technology integration and continuous process improvement. Compile and report out these findings.
• Rely on insights to help evolve and adapt the design of optimizing reimbursement solutions, carefully considering existing processes, workflow intricacies, and operational nuances to ensure seamless integration, while maintaining consistency with our patient care model and clinical excellence values.
Stakeholder Engagement
• Foster strong relationships with internal key stakeholders and front-line end users (providers)
• Coordinate communication between impacted teams to help gain alignment and problem solve barriers
• Host focus groups and send surveys to gather & synthesize feedback pre/during/and post-implementation of mini tests, pilots, and projects
Idea Generation & Research
• Be a thought partner with generating creative and impactful process improvement and reimbursement optimization ideas through data-driven insights
• Stay updated on industry trends, best practices, and emerging technologies relevant to physical therapy operations & payor trends
Minimum Education
Required:
• Associate degree in business, operations management, healthcare, or related field
Preferred:
• Bachelor’s degree preferred in relevant field of study
Minimum Experience
Required:
• 2+ years in a consultant-type role, preferably in the health care related field and familiar with revenue cycle & payor rules.
Preferred:
• Direct patient-facing and/or provider-facing experience within retail healthcare delivery
• Experience in referral/prescription intake process innovation and patient adherence/care solution development and implementation
Knowledge Skills and Abilities
• Proficient analytical skills to interpret data, identify trends, and make data-driven decisions
• Proven ability to foster a culture of innovation, encouraging the exploration of new tools and technologies for patient engagement
• Strong interpersonal skills with ability to collaborate effectively across diverse business units
• High level of adaptability, creativity, and problem-solving ability in a dynamic healthcare environment.
• Previous experience in healthcare operations, patient engagement, or related roles is highly desirable
• Demonstrated ability and strong desire to work collaboratively within a team environment
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