Mayo Clinic
Senior Manager- Enterprise Denial Prevention & Analytics (PRIZM)
Mayo Clinic, Rochester, Minnesota, United States, 55901
Senior Manager
Enterprise Denial Management- PRIZM
The Senior Manager
Enterprise Denial Management- PRIZM is a key strategic leadership role within our Revenue Cycle organization. This position is responsible for overseeing and advancing enterprise-level prevention and resolution efforts across a large, multi-site academic health system. The successful candidate will be responsible for leading a high-performing team of Senior Business Analysts and Denial Prevention Associates, while also managing and optimizing the use of the PRIZM denial management engine and analytics platform. The role involves cross-functional leadership, interfacing with stakeholders across clinical, operational, and administrative teams to proactively identify denial trends, drive root cause analysis, and execute system-wide strategies to reduce denial volume and improve reimbursement accuracy. Key Responsibilities: Provide strategic and operational oversight for enterprise denial management activities and prevention initiatives. Lead, mentor, and develop a team of Senior Business Analysts and Denial Prevention Associates. Manage and optimize use of the PRIZM engine and associated analytics dashboards, ensuring effective modeling, governance, and insight generation. Collaborate across clinical and non-clinical departments to lead denial prevention workgroups focused on process redesign and revenue integrity. Establish, monitor, and report on key performance indicators (KPIs) to assess and improve denial management outcomes. Engage with physician and administrative leadership to identify system-level gaps and drive improvement initiatives. Participate in strategic planning efforts, serving as a thought leader and advisor to Revenue Cycle leadership. Represent the health system in external industry forums (e.g., HFMA, EPIC academic working groups) to stay ahead of evolving denial trends and share best practices. Facilitate complex problem-solving efforts involving payor trends, documentation workflows, clinical collaboration, and contract interpretation. Translate enterprise strategy into measurable, effective actions within the Denial Management program. During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps. Qualifications: Required: Bachelor's degree in Business, Healthcare, Finance, or a related field and 10 years of relevant experience, including at least 5 years in a leadership role OR 14 years of relevant experience (in lieu of degree), including 5 years leading people, projects, or programs. Demonstrated experience managing teams, projects, and complex systems in healthcare or consulting environments. Proven analytical expertise with ability to identify trends, synthesize data, and present insights to senior leadership. Strong executive presence and communication skills with ability to engage diverse stakeholder groups. EPIC experience in a revenue cycle context. Prior experience with denial management and denial analytics platforms. Preferred: Master's degree in Business Administration, Health Administration, or related field. Experience within an academic medical center or large integrated health system. Active participation in professional organizations such as HFMA or NAHAM. Background in consulting with success at managing large scale healthcare revenue cycle improvement initiatives, healthcare analytics and denials management. Key Competencies: Strategic Thinking & Vision Alignment Complex Problem Solving & Decision Making Cross-Functional Collaboration & Influence Data Analytics & Trend Identification Project Management & Continuous Improvement Change Leadership & Organizational Agility Strong Emotional Intelligence & Conflict Resolution High Integrity & Accountability Additional Information: Travel may be required based on project or system needs. This role operates in a highly matrixed and fast-paced environment requiring adaptability, proactive leadership, and sound judgment. Exemption Status: Exempt Compensation Detail: $138,257.60 - $200,512.00 / year Benefits Eligible: Yes Schedule: Full Time Hours/Pay Period: 80 Schedule Details: Business Hours: Monday-Friday 8 a.m.-5 p.m. CST Weekend Schedule: N/A International Assignment: No Site Description: Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Equal Opportunity: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. Recruiter: Miranda Grabner
Enterprise Denial Management- PRIZM
The Senior Manager
Enterprise Denial Management- PRIZM is a key strategic leadership role within our Revenue Cycle organization. This position is responsible for overseeing and advancing enterprise-level prevention and resolution efforts across a large, multi-site academic health system. The successful candidate will be responsible for leading a high-performing team of Senior Business Analysts and Denial Prevention Associates, while also managing and optimizing the use of the PRIZM denial management engine and analytics platform. The role involves cross-functional leadership, interfacing with stakeholders across clinical, operational, and administrative teams to proactively identify denial trends, drive root cause analysis, and execute system-wide strategies to reduce denial volume and improve reimbursement accuracy. Key Responsibilities: Provide strategic and operational oversight for enterprise denial management activities and prevention initiatives. Lead, mentor, and develop a team of Senior Business Analysts and Denial Prevention Associates. Manage and optimize use of the PRIZM engine and associated analytics dashboards, ensuring effective modeling, governance, and insight generation. Collaborate across clinical and non-clinical departments to lead denial prevention workgroups focused on process redesign and revenue integrity. Establish, monitor, and report on key performance indicators (KPIs) to assess and improve denial management outcomes. Engage with physician and administrative leadership to identify system-level gaps and drive improvement initiatives. Participate in strategic planning efforts, serving as a thought leader and advisor to Revenue Cycle leadership. Represent the health system in external industry forums (e.g., HFMA, EPIC academic working groups) to stay ahead of evolving denial trends and share best practices. Facilitate complex problem-solving efforts involving payor trends, documentation workflows, clinical collaboration, and contract interpretation. Translate enterprise strategy into measurable, effective actions within the Denial Management program. During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps. Qualifications: Required: Bachelor's degree in Business, Healthcare, Finance, or a related field and 10 years of relevant experience, including at least 5 years in a leadership role OR 14 years of relevant experience (in lieu of degree), including 5 years leading people, projects, or programs. Demonstrated experience managing teams, projects, and complex systems in healthcare or consulting environments. Proven analytical expertise with ability to identify trends, synthesize data, and present insights to senior leadership. Strong executive presence and communication skills with ability to engage diverse stakeholder groups. EPIC experience in a revenue cycle context. Prior experience with denial management and denial analytics platforms. Preferred: Master's degree in Business Administration, Health Administration, or related field. Experience within an academic medical center or large integrated health system. Active participation in professional organizations such as HFMA or NAHAM. Background in consulting with success at managing large scale healthcare revenue cycle improvement initiatives, healthcare analytics and denials management. Key Competencies: Strategic Thinking & Vision Alignment Complex Problem Solving & Decision Making Cross-Functional Collaboration & Influence Data Analytics & Trend Identification Project Management & Continuous Improvement Change Leadership & Organizational Agility Strong Emotional Intelligence & Conflict Resolution High Integrity & Accountability Additional Information: Travel may be required based on project or system needs. This role operates in a highly matrixed and fast-paced environment requiring adaptability, proactive leadership, and sound judgment. Exemption Status: Exempt Compensation Detail: $138,257.60 - $200,512.00 / year Benefits Eligible: Yes Schedule: Full Time Hours/Pay Period: 80 Schedule Details: Business Hours: Monday-Friday 8 a.m.-5 p.m. CST Weekend Schedule: N/A International Assignment: No Site Description: Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Equal Opportunity: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. Recruiter: Miranda Grabner