Adventist Health
Manager, Revenue Analytics (Sonora)
Adventist Health, Sonora, California, United States, 95370
Overview
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Manager, Revenue Analytics (Sonora)
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Adventist Health . Adventist Health Sonora has been one of the area’s leading healthcare providers since 1900. We operate a 72-bed hospital, 30 medical offices, comprehensive cancer care, and a wide range of services across Tuolumne and Calaveras counties and surrounding areas. Sonora is known for its friendly community and access to outdoor activities, with proximity to Yosemite National Park and Lake Tahoe. Job Summary
Leads day-to-day operations of the Revenue Management department to maximize reimbursement and reduce denials through data-driven insight, payer engagement, revenue cycle collaboration, and operational improvement. Serves as a key liaison between Finance, Hospital operators, Payer Relations, Case Management, Utilization Management, Patient Access, Patient Financial Services, Revenue Integrity and other Revenue Cycle functions to ensure contract compliance, mitigate revenue risk, and strengthen payer accountability. Job Requirements
Education and Work Experience: Bachelor’s Degree or equivalent combination of education/related experience: Required Master\u2019s Degree: Preferred Five years\' related experience in Revenue Cycle Management and/or Managed Care contracting and analysis: Preferred One year of leadership experience: Preferred Essential Functions
Directs the weekly High Dollar Review process across multiple hospitals, coordinating with Patient Access, Case Management, Utilization Management, Billing, Patient Financial Services, and other revenue cycle disciplines to surface systemic gaps and improve reimbursement. Leads denial management strategy, including root cause analysis, denial prevention initiatives, and tracking resolution performance across all payer types. Coordinates with all stakeholders to ensure timely appeal submission and to strengthen payer accountability for overturning inappropriate denials. Monitors denial trends to identify systemic issues and drives corrective action to improve reimbursement outcomes. Identifies and removes barriers to clean claims, timely payment, and full reimbursement. Serves as key liaison between Finance, Payer Relations, Case Management, Utilization Management, and Revenue Cycle to ensure contracts are optimized, compliance maintained, and reimbursement risk mitigated. Collaborates in payer escalation and Joint Operating Committee forums, presenting data-driven cases to secure authorization processes, correct DOFR misalignments, and resolve denials. Oversees contract performance analytics, ensuring payer adjudication aligns with negotiated terms and flagging discrepancies. Reviews ATB (Aged Trial Balance) to identify reimbursement risks by payer behaviors, service line, and internal deficiency trends. Assists the Finance team to prepare and analyze AR Reserve, identifying trends that significantly impact net revenue. Builds, coaches, and mentors a high-performing analytics team that integrates clinical and financial insights to improve net revenue yield. Ensures timely completion of performance reviews, orientation, compliance training, and continuing education for staff. Maintains a supportive work environment through effective selection, orientation, management, and staff development. Interviews, hires, and trains employees in a timely manner. Performs other job-related duties as assigned. Organizational Requirements
Adventist Health requires all associates to receive required vaccinations where applicable, with medical or religious exemptions considered. E-Verify participation is required. For more information, visit the E-Verify page on our careers site. By applying, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices. The estimated base pay for this position is $132,384 to $198,577. Additional compensation may be available based on experience, differentials, shift incentives, bonuses, and other factors. Base pay is only part of the total rewards package, and a comprehensive benefits program is available for qualifying positions. Please contact our Talent Acquisition team for more information. About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Our team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven to live God\u2019s love by inspiring health, wholeness and hope. Seniority level
Mid-Senior level Employment type
Full-time Job function
Accounting/Auditing and Finance Industries
Hospitals and Health Care Get notified about new Revenue Manager jobs in Sonora, CA.
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Join to apply for the
Manager, Revenue Analytics (Sonora)
role at
Adventist Health . Adventist Health Sonora has been one of the area’s leading healthcare providers since 1900. We operate a 72-bed hospital, 30 medical offices, comprehensive cancer care, and a wide range of services across Tuolumne and Calaveras counties and surrounding areas. Sonora is known for its friendly community and access to outdoor activities, with proximity to Yosemite National Park and Lake Tahoe. Job Summary
Leads day-to-day operations of the Revenue Management department to maximize reimbursement and reduce denials through data-driven insight, payer engagement, revenue cycle collaboration, and operational improvement. Serves as a key liaison between Finance, Hospital operators, Payer Relations, Case Management, Utilization Management, Patient Access, Patient Financial Services, Revenue Integrity and other Revenue Cycle functions to ensure contract compliance, mitigate revenue risk, and strengthen payer accountability. Job Requirements
Education and Work Experience: Bachelor’s Degree or equivalent combination of education/related experience: Required Master\u2019s Degree: Preferred Five years\' related experience in Revenue Cycle Management and/or Managed Care contracting and analysis: Preferred One year of leadership experience: Preferred Essential Functions
Directs the weekly High Dollar Review process across multiple hospitals, coordinating with Patient Access, Case Management, Utilization Management, Billing, Patient Financial Services, and other revenue cycle disciplines to surface systemic gaps and improve reimbursement. Leads denial management strategy, including root cause analysis, denial prevention initiatives, and tracking resolution performance across all payer types. Coordinates with all stakeholders to ensure timely appeal submission and to strengthen payer accountability for overturning inappropriate denials. Monitors denial trends to identify systemic issues and drives corrective action to improve reimbursement outcomes. Identifies and removes barriers to clean claims, timely payment, and full reimbursement. Serves as key liaison between Finance, Payer Relations, Case Management, Utilization Management, and Revenue Cycle to ensure contracts are optimized, compliance maintained, and reimbursement risk mitigated. Collaborates in payer escalation and Joint Operating Committee forums, presenting data-driven cases to secure authorization processes, correct DOFR misalignments, and resolve denials. Oversees contract performance analytics, ensuring payer adjudication aligns with negotiated terms and flagging discrepancies. Reviews ATB (Aged Trial Balance) to identify reimbursement risks by payer behaviors, service line, and internal deficiency trends. Assists the Finance team to prepare and analyze AR Reserve, identifying trends that significantly impact net revenue. Builds, coaches, and mentors a high-performing analytics team that integrates clinical and financial insights to improve net revenue yield. Ensures timely completion of performance reviews, orientation, compliance training, and continuing education for staff. Maintains a supportive work environment through effective selection, orientation, management, and staff development. Interviews, hires, and trains employees in a timely manner. Performs other job-related duties as assigned. Organizational Requirements
Adventist Health requires all associates to receive required vaccinations where applicable, with medical or religious exemptions considered. E-Verify participation is required. For more information, visit the E-Verify page on our careers site. By applying, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices. The estimated base pay for this position is $132,384 to $198,577. Additional compensation may be available based on experience, differentials, shift incentives, bonuses, and other factors. Base pay is only part of the total rewards package, and a comprehensive benefits program is available for qualifying positions. Please contact our Talent Acquisition team for more information. About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Our team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven to live God\u2019s love by inspiring health, wholeness and hope. Seniority level
Mid-Senior level Employment type
Full-time Job function
Accounting/Auditing and Finance Industries
Hospitals and Health Care Get notified about new Revenue Manager jobs in Sonora, CA.
#J-18808-Ljbffr