Senior Manager, Rules and Format Management

The Senior Manager, Rules and Format Management is a critical leader of the intellectual capital building process for athenahealth, charged with managing the integrity of the company?s proprietary knowledge contained in the Rules Engine. In particular, the Senior Manager, Rules and Format Management will tactically manage the Rules Operations team and the life cycle of all rules ?from business requirement scoping, technical development, QA testing, through to implementation.

The Senior Manager, Rules and Format Management will report directly to the Director, Payer Performance Management.

The Senior Manager, Rules and Format Management is responsible for all aspects of Rules Operations, which is designed to assist various stakeholders within the athenahealth organization to solve complex billing problems that impact client and organizational performance. In doing so, the Senior Manager, Rules and Format Management will provide on-going stewardship of athenahealth?s proprietary Rules Engine. Specifically, the Senior Manager, Rules and Format Management will, among other things:


Foster a company-wide enthusiasm for Rules as one of athenahealth?s key product differentiators;

Ensure that athenahealth remains at the forefront of industry changes/payer changes that impact the claim cycle and our clients? ability to submit the cleanest claims in healthcare;

Manage a high performance team, set goals, and build employee engagement;

Lead the implementation of assigned projects or operational issue resolution;

Develop close working relationships and drive activities to support other managers at athenahealth;

Prepare and maintain strategic and operations plans to determine division goals and priorities, and ensure delivery of these goals;

Drive continuous improvement aimed at refinement of core business processes;

Meet tight deadlines in a time sensitive and resource constrained project environment;

Partner with other groups and departments inside athena and externally to align Payer Performance Management and stakeholder needs and maximize overall value delivered by the department;

Organize, build, and manage processes to support the development of intellectual capital (e.g. best practices, new product and service offerings, etc.);

Define policies, procedures, training and documentation requirements to support effective, well communicated and timely process and policy changes;

Establish metrics to ensure high quality work product and identifying opportunities for procedural improvement;

Demonstrate commitment to athenahealth's Corporate Compliance Code, including escalation of all compliance issues through the chain of command and to the company's Compliance Officer and/or General Counsel;

Work closely with the Director, Payer Performance Management to develop and implement initiatives to advance department goals;

Represent the Director, Payer Performance Management as necessary;

Other duties as assigned by the Director, Payer Performance Management.

Required of all athenahealth employees:

The Senior Manager Rules must adhere to the business and cultural goals required by all employees of athenahealth.

Performance

Dedication to the corporate mission to become the most trusted and effective business service to health care providers in the world;

Commitment to athenahealth?s social mission to improve the quality of healthcare for all;

Commitment to athenahealth?s Corporate Compliance Code, including escalation of all compliance issues through the chain of command and to the company?s Compliance Officer and/or General Counsel;

Unconditional support of athenahealth?s cultural mission to be a community of teachers, learners and winners, including:

Belief in the primacy of the group over the individual ? that ?super-performers? are those who most help the performance of those around them rather than those who produce the most themselves;

Creating a virtuous circle of learning and innovation through fostering his/her innate curiosity and desire to: 1) master his/her job, 2) innovate in his/her area of responsibility, whatever its scope and 3) teach other athenistas about what s/he has learned;

Demonstrate unconditional positive regard for the personal worth (distinct from a particular individual?s actions) of all other athenistas, and act accordingly;

Fueled by the passionate desire to make his/her role and athenahealth a terrific success, every athenahealth employee will do what it takes to get the job done, including sometimes working unpredictable, long hours to perform a diverse array of tasks.

Skills

High level understanding of the three major services lines and of the organization?s responsibility for delivering on them;

Understanding of the Balanced Scorecard and each department?s responsibilities under it;

Excellent communication skills (particularly listening and speaking);

Maniacal attention to detail;

Willing/excited to work in a fast-paced, but sometimes intense, rapidly expanding company;

Strong computer literacy and/or the comfort, ability and desire to advance technically.

Bachelor?s degree or equivalent experience required; MBA or Master?s degree preferred;

CPC credential preferred;

Ability to build, manage, and motivate a high-performing team;

Project management and/or consulting experience desired;

Experience or interest in systems configuration and implementation, beneficial;

Demonstrated ability to lead and influence others to achieve desired results;

Exceptional communication and influence skills;

Strong organizational skills and attention to detail;

Advanced understanding of, or strong ability and desire to learn, the process of Medical Billing;

ANSIx12 837P/I or other X12 Transaction knowledge, preferred;

Deep understanding of health plan and practice management operations;

Strong analytical skills;

Ability to keep track of numerous detail-intensive, interdependent tasks and ensure their accurate completion;