[Hiring] Denial Prevention Process Improvement Specialist I @Mass General Brigham

Role Description

As a member of the Denial Prevention Team, the Denial Prevention Process Improvement Specialist will drive continual improvement efforts to prevent insurance rejections and related write offs.
• Responsible for analyzing, designing, and implementing process improvement initiatives to enhance the quality of patient care, operational efficiency, and patient safety.
• Identify areas for improvement, streamline processes, and promote a culture of continuous improvement within the hospital.
• Utilize knowledge of revenue cycle and hospital operations to interpret denial data, identify trends and translate findings into actionable prevention strategies.
• Analyze existing denial prevention healthcare processes, workflows, and procedures to identify inefficiencies, bottlenecks, and areas for improvement.
• Develop and implement performance metrics and key performance indicators to measure process effectiveness and track improvement initiatives.
• Lead or participate in quality improvement projects to optimize patient care, patient safety, and healthcare outcomes.
• Gather and analyze data related to process performance, patient outcomes, and other quality-related indicators to inform improvement efforts.
• Conduct root cause analysis to identify the underlying factors contributing to process issues or adverse events.
• Collaborate with cross-functional teams to design and implement redesigned processes that are efficient, standardized, and aligned with best practices.
• Facilitate change management efforts to ensure successful implementation of process improvements and promote staff buy-in.
• Continuously monitor and evaluate the effectiveness of implemented improvements and make adjustments as needed.

Qualifications
• Bachelor's Degree in a related field of study required
• 1-2 years of process improvement/quality management experience preferred
• Strong data analysis and statistical skills to interpret performance data and identify trends.
• Familiarity with healthcare operations, patient care processes, and healthcare quality standards.
• Excellent communication and interpersonal skills to collaborate with various stakeholders and present findings and recommendations.
• Strong problem-solving and critical-thinking skills to identify process issues and implement effective solutions.
• Proficiency in project management to lead and coordinate improvement projects from initiation to completion.
• Skilled in Excel functions, formulas, and pivot tables.

Requirements
• Remote Type: Remote
• Work Location: 399 Revolution Drive
• Scheduled Weekly Hours: 40
• Employee Type: Regular
• Work Shift: Day (United States of America)
• Pay Range: $63,648.00 - $90,750.40/Annual
• Grade: 6

Benefits

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.