Program Manager, Health Homes Billing

New York, NY / Full-time

About Relevant

Relevant builds tools to support the work of community health providers. Our analytics platform is used by community health centers around the country, including several which have recently won awards for innovative use of technology. Our care management platform is the leading software solution within New York State’s Medicaid Health Homes program.

About Health Homes

Health Homes is a major initiative to intervene with high-risk Medicaid patients. The program was launched in 2010, as part of the Affordable Care Act. Health Home patients may have multiple chronic conditions, substance use challenges, or serious mental illness; they might be homeless or incarcerated. The goal is to improve health outcomes while also reducing total system costs, with a special focus on preventing unnecessary hospitalizations.

Dozens of organizations, from hospitals like Mount Sinai to community-based organizations like Housing Works and The Alliance, use our care management platform to collaborate on patient care and track progress for Health Home patients.

The role

We’re looking for a detail-oriented generalist to run a set of key business processes for our Health Home customers. Please note: this position is not as specialized as a typical medical billing job; if you’re good at spreadsheets, read on!

Main Responsibilities

  • Manage our billing operations. Manage the claim submission cycle for our Health Homes, which begins with submitting claims to payers and ends with ensuring the right amounts are flowing to each care management agency. Monitor each step of this process, digging into the details to figure out which claims aren’t getting paid and why.

  • Become our subject matter expert. Learn everything there is to know about Health Home billing requirements, digesting guidance from NYSDOH and attending statewide calls as needed.

  • Keep our customers in the loop. Prepare polished, friendly “billing update” emails and slide decks for our Health Home customers. Answer billing questions from Health Homes and CMAs via email and phone.

  • Strengthen MCO relationships. You’ll be the primary liaison to a dozen key Medicaid Managed Care Organization partners. Win their trust as an effective collaborator, and resolve problems with individual and systemic claim denials.

  • Help our services team. In addition to billing, you’ll have the opportunity to take on a range of responsibilities—from user trainings, support, and system documentation to developing SQL reports, syncing data with MAPP and other systems, and providing feedback to our product and engineering team about how to improve our platform.

Preferred experience

  • 5+ years experience. Strong applicants may come from a variety of backgrounds, including within healthcare (administration, billing, finance, program management, program implementation) or outside (operations, research, finance, administration, customer success).

What we're looking for

  • Systems thinking. You’ve successfully managed complex business processes, and enjoy finding ways to improve them. You like creating documentation and checklists to make sure steps don’t get missed.

  • Sweats the details. You’re good at troubleshooting and getting to the bottom of issues. (Here, typical issues might be why a particular claim wasn’t paid, or why a check amount doesn’t match a remittance total.)

  • Tech savvy. You know a lot about Excel (e.g. Pivot Tables), and you can pick up new software skills quickly. We don’t expect you to know SQL, but you’d welcome the opportunity to learn.

  • Stakeholder management. You’ll excel at building relationships with all the organizations involved in the Health Homes world. Your style is friendly and collaborative, but you also know how to push for answers and escalate when necessary.

  • Excellent communication skills. We're looking for candidates who can craft strong client-facing emails, documentation, and presentation decks, as well as communicate effectively within Relevant.

  • A desire to improve health outcomes, with a focus on equity and social justice. We’re building tools used by safety-net organizations that are fighting health disparities, and are looking for candidates who find this focus compelling.

  • Be nice, and value collaboration. We think feelings matter a lot. We’re looking for people who are easy to work with and whom others always want on their team.

Compensation

The base salary range for this position is $75-100K/year. This is negotiable and depending on experience. Significant equity in the form of options, company 401(k) contribution, and other benefits are in addition.

Working at Relevant

  • Join a small team of people (currently, there are 24 of us) who love what we do and continually strive to delight our customers.

  • Help us build a company culture that's friendly, respectful, and encourages continual learning.

  • Competitive salary, excellent benefits (we pay 100% of employee healthcare premiums), 401(k) with employer contribution, generous vacation policy, and a general emphasis on happiness and sanity.

When we're not experiencing a pandemic, our office space in downtown Manhattan is provided by WeWork, with the attendant nice amenities: social spaces, lots of natural light, reasonably good coffee and espresso. Here's the common area:

WeWork City Hall Common Space Photo

How to Apply

Send an email to [email protected] with the subject line “Program Manager, Health Homes Billing.” When responding, attach a resume in PDF format and include a note in the body of your email explaining your interest in the position. Please include the phrase “tiny barley parachute” somewhere in your note.

Relevant is an equal opportunity employer. Applicants who identify with groups that are under-represented in the technology industry are strongly encouraged to apply.