Manager, Revenue Analytics

Overview: The Revenue Analytics Manager for Emergency Medicine is responsible for overseeing, monitoring, and improving professional billing revenue performance through proactive charge review, provider engagement, compliance collaboration, and cross-organizational coordination. This role serves as a key liaison between the Emergency Medicine department, hospital financial leadership, Yale Medicine, and an external coding vendor to ensure accurate, timely, and compliant billing and revenue capture. The position plays a critical role in identifying revenue risks, resolving documentation deficiencies, and driving continuous improvement in revenue integrity through reporting, reconciliation, and provider education.(Focus on the Overview above, not the Principal responsibilities listed below).

Responsibilities: Perform regular review of charge work queues to identify missing, incomplete, or non-compliant documentation impacting billing. Conduct weekly review of hospital deficiencies and outstanding charges, ensuring timely resolution and escalation when needed. Collaborate with Yale New Haven Health System to improve clinical workflows that may affect charge capture or result in denials, and perform reconciliation of professional and facility charges, identifying discrepancies and optimizing revenue opportunities. Maintain regular communication with department leadership and faculty to address documentation issues and chart compliance for billing. Distribute weekly reconciled chart reports to providers highlighting outstanding issues and required follow-up. Meet regularly with providers to review individual and group-level revenue performance, documentation trends, and opportunities for improvement. Prepare and distribute monthly revenue reports to department leadership. Identify trends, risks, and opportunities within financial subdivisions, escalating concerns as needed. Analyze revenue data to detect potential lost revenue, workflow inefficiencies, or documentation gaps. Serve as subject matter expert for the department and is responsible for staying abreast of all federal, state, and payer/carrier guidelines and regulations. Lead monthly meetings with the external coding vendor to review performance, discuss potential lost revenue, and address coding trends. Collaborate closely with Yale Medicine on revenue integrity initiatives, reporting alignment, and follow-up actions. Schedule and facilitate meetings with Yale Medicine, ensuring reports are presented to Medical Directors and departmental leadership. Work in partnership with Compliance on risk audits, internal audit findings, and corrective action plans. Support implementation of audit recommendations and monitor ongoing compliance with regulatory and institutional standards. Identify workflow gaps, documentation risks, and process inefficiencies; recommend and implement solutions. Serve as a resource for ad-hoc requests from the department. Perform additional duties and projects as assigned in support of departmental and institutional goals.

Required: Skills and Abilities1. Strong understanding of the hospital based billing cycle and processes.2. Excellent working knowledge of medical office/hospital systems, medical record management software (Epic), Outlook email and related software applications.3. Well-developed managerial, decision-making, planning, organizational, problem-resolution and leadership skills with the demonstrated ability to influence and manage people on a day-to-day basis.4. Ability to interpret and communicate complex revenue and compliance data to clinical providers.5. Excellent organizational, analytical, and communication skills. Ability to manage multiple priorities.

Preferred: Skills and Abilities1. Knowledge of Emergency Medicine revenue cycle. Principal Responsibilities1. In collaboration with Epic Project Team, ensure the integrity of EPIC data that is critical to producing accurate Professional Revenue Cycle processes and reporting such as professional billing codes, pricing, work RVU, provider, department, bill areas, report groupers, etc. Manage the process to monitor and resolve charges held in Epic work queues related to pricing. Establish consistent process to ensure timeliness of code and price activation. Maintain reliable storage of carrier fee schedules. Understand the Epic infrastructure and logic for charging, claim production and payment or denial posting. 2. Establish schedules, set timeframes, deadlines and assign Professional Revenue Cycle Specialists and/or Analysts that perform work on pricing, code management, payment variances, claims scrubber maintenance and contract management. 3. Manage staff including work assessment, development, hiring, training and evaluation of ongoing needs. 4. Manage the payment variance process for all carriers. Evaluate software, establish processes and ensure systems are in place to identify and track all incorrect payments and appeals. 5. Manage and maintain the claims scrubbing system to minimize claim denials and payment delays. Ensure timely review of edit requests. Establish an annual review of existing edits. Run analyses on current charges to determine impact of changes. 6. Manage relations with all third party contracted payers. Coordinate communications; establish regular meetings in person, by phone or internet to discuss outstanding "tracker" issues regarding payments, denials or other processes until resolved. Communicate with managed care contracting staff regarding carrier payment performance. 7. Oversee distribution of Payer Alerts to all staff. 8. Establish reliable and timely processes and procedures related to Payer Contract Management. Track carrier performance compared to negotiated and ideal contract elements. Identify, monitor and communicate variations. Participate in the development of Yale Medicine Administration (YMA) requirements and improvements in processes to manage payer contracts and performance. 9. Conduct detailed and comprehensive fee schedule analyses to support contract negotiations based on knowledge and access to national, regional and community data. Perform predictive analyses to determine the financial impact of fee schedule changes on the overall practice, individual departments and physicians. Prepare special analyses and reports to develop and support financial recommendations to Chairs and Administrators, YNHHS Contracting and YMA Administration to address specific concerns with respect to contracting and reimbursement issues. 10. Manage relationship with third party vendor for Claims Scrubbing, Contract Management and payment Analysis. 11. Provide support to Professional Revenue and Integrity Specialists and Managers on investigative projects to assess changes in billing and collection performance of specific clinical departments or physicians. Assume project management of major reimbursement projects affecting YMA strategic goals and objectives. 12. Monitor internal monthly revenue cycle statistics to evaluate effectiveness of processes and any changes implemented. Assist with research, preparation and analysis of financial studies and reports. Identify trends or items requiring corrective action. Develop and report on key performance metrics (KPI) to monitor effect of change and measure success of efforts. 13. Function as liaison with various organizations data delivery and benchmarking analysis with other academic institutions. Research, develop and implement processes to communicate performance on these measures to YMA. Evaluate programs and software, make recommendations for practice. Manage YMA responses to annual surveys. 14. Develop and maintain policies and procedures relevant to Contract management and payment analysis and ensure posting on the web. Required

Education and Experience: Bachelor's Degree and four years of experience in the analysis of business needs and development of related business systems or the equivalent combination of education and experience.

Required: License(s) or Certification(s) Use or working knowledge of EPIC or other Practice Management and Electronic Health Record applications.

Posting Disclaimer: Salary offers are determined by a candidate's qualifications, experience, skills, and education in relation to the position requirements, along with the role's grade profile and current internal and external market conditions. The intent of this job description is to provide a representative summary of the essential functions that will be required of the position and should not be construed as a declaration of specific duties and responsibilities of the position. Employees will be assigned specific job-related duties through their hiring department. The University is committed to basing judgments concerning the admission, education, and employment of individuals upon their qualifications and abilities and seeks to attract to its faculty, staff, and student body qualified persons from a broad range of backgrounds and perspectives. In accordance with this policy and as delineated by federal and Connecticut law, Yale does not discriminate in admissions, educational programs, or employment against any individual on account of that individual's sex, sexual orientation, gender identity or expression, race, color, national or ethnic origin, religion, age, disability, status as a special disabled veteran, veteran of the Vietnam era or other covered veteran. Inquiries concerning Yale's Policy Against Discrimination and Harassment may be referred to the Office of Institutional Equity and Accessibility (OIEA).NoteYale University is a tobacco-free campus.