Boston Medical Center (BMC)

Chief of Staff

• Serve as the local Finance executive overseeing all aspects of financial strategy, planning, forecasting, operations, and reporting
• Oversee the implementation and development of the Hospital’s annual operating and capital budgets
• Provide executive-level financial insights to the Hospital CEO and Board
• Lead integration of financial planning with clinical and operational strategies
• Champion data governance and financial analytics for evidence-based decision-making
• Ensure compliance with regulatory, audit, and reporting requirements

Chief of Staff – Executive Director, Finance

Business Analyst

• Analyzes medical records for compliancy with standards, rules and regulations related to patient information
• Analyzes findings captured in databases for trends, changes and areas of concern
• Creates reports, maintains databases and tracks statistical information
• Performs specialized professional level administrative, organizational, systems, budgetary and related analysis for hospital programs and activities

Health Information Management Analyst

Operations

• Responsible for the operational functions of the Professional Coding Operations team for BUMG.
• Plays a strategic role in validating the accuracy of CPT, HCPCS and diagnosis code assignment by coders, physicians and non –physician practitioners.
• Works closely with key revenue cycle stakeholders to understand reasons for denials, root cause analysis, and feedback to providers.
• Supervises professional billing coding staff.
• Partners with Coding Education Team to identify trends in coding practices and assists with developing feedback and education to providers.
• Reviews coding denials to resolve and identify trends and provides feedback to providers and departments.
• Performs quality assurance reviews of inpatient and outpatient records to assess and report on the effectiveness of training programs and quality of coders.
• Provides in-service training and feedback to coding staff regularly, including coding changes and updates.
• Oversees coding operations to ensure organizational goals are being met.

Manager, Professional Billing Coding Operations

Director

• Responsible for the Health System’s OEH service and business operations
• Oversee management of all employee health services staff across the system
• Engage collaboratively with all stakeholders to ensure timely and high-quality delivery of employee health services
• Lead strategic planning for improvement and expansion of employee health and safety
• Develop and implement cost-saving strategies for the organization around workers compensation expenditures

Senior Director, Occupational and Employee Health

Supply Chain

• Transform raw data into actionable insights that lead to cost and waste reduction, improved efficiency, and problem solving.
• Collect and analyze data from various internal and external sources on all areas of supply chain operations to develop actionable insights and performance improvement.
• Measure and trend monthly supply chain performance; work with supply chain leadership to develop KPIs and targets.
• Ensure data is accurate and high quality; identify opportunities for data quality improvements that lead to reporting automation and efficiency.
• Develop and publish standard reports for supply chain functional teams to enhance and inform their workflows.
• Collaborate with cross-functional teams to understand business requirements and provide analytical solutions.
• Analyze work processes to drive efficiency, service level improvement and cost reduction.

Senior Supply Chain Analyst

Analyst

• The Applications Analyst is responsible for proactively identifying opportunities to apply technologies to business processes.
• Informs and advises customers on information system technologies' functionality, costs, benefits, and implementation requirements.
• Coordinates multi-system solutions to clarify interdependencies (and interfaces).
• Develops all aspects of the project plans (scope, definition, testing, delivery and support).

Applications Analyst I

Human Resources

• The Applications Analyst II is a business specialist and technology generalist responsible for aligning technology solutions with business strategies
• Responsible for proactively identifying opportunities to apply technologies to business processes by informing and advising customers on information system technologies' functionality, costs, benefits, and implementation requirements
• Functions as technical liaison and broker of services with various vendors
• Develop and maintain credibility and effective working relations with both customer management and IT personnel
• Demonstrate an understanding of business problems, as well as IT strategies, issues, and priorities
• Seek opportunities to apply technology to improving business processes within strategic system goals

Applications Analyst – EHR

Manager

• Negotiate and draft/edit moderate to complex, non-routine contracts
• Prepare complex requests for proposals
• Review complex solicitations and prepare specialized and/or non-routine responses
• Provide contractual and authoritative guidance to internal business teams
• Develop negotiation strategy and lead negotiations on complex contractual issues
• Manage contract change control process
• Engage stakeholders in contracting and RFP decisions
• Conduct market research to maintain knowledge of current industry trends
• Mentor and train less experienced contracting staff

Contract Manager

Insurance

• Monitors accounts routed to registration, referral and prior authorization work queues and clears work queues by obtaining all necessary patient and/or payer-specific financial clearance elements in accordance with established management guidelines
• Maintains knowledge of and complies with insurance companies’ requirements for obtaining prior authorizations/referrals, and completes other activities to facilitate all aspects of financial clearance
• Acts as subject matter experts in navigating both the BMC and payer policies to get the appropriate approvals (authorizations, pre-certs, referrals, for example) for the scheduled care to proceed
• Supports BMC staff at all levels for hands-on help understanding and navigating financial clearance issues
• Obtains and clearly documents all referral/prior authorizations for scheduled services prior to admission within the Epic environment
• Works collaboratively with primary care practices, specialty practices, referring physicians, primary care physicians, insurance carriers, patients and any other parties to ensure that required managed care referrals and prior authorizations for specified specialty visits and other services are obtained and appropriately recorded in the relevant practice management systems for patient appointments/visits prior to scheduled patient visits or retro-actively if not in place at the time of the appointment/visit
• Ensure that approval numbers are appropriately linked to the relevant patient appointment/visit
• When it is determined that a valid referral does not exist, utilize computer-based tools or contact the appropriate party to obtain/generate referral/authorization and related information
• Collaborate with patients, providers, and departments to obtain all necessary information and payer permissions prior to patients’ scheduled services
• Communicates with patients, providers, and other departments such as Utilization Review to resolve any issues or problems with obtaining required referral/prior authorizations
• Escalates accounts that have been denied or will not be financially cleared as outlined by department policy
• Maintain patient confidentiality, including but not limited to, compliance with HIPAA
• Attend all necessary hospital and department training as required
• Perform other related duties as assigned or required

Insurance Verification Specialist

Financial Planning and Analysis

• Facilitates the financial management associated with planning, negotiating, setting up, managing, and closing out clinical research studies
• Evaluates study protocols and develops accurate budgets
• Meets with research personnel to identify and quantify pertinent information impacting clinical trial finances
• Distinguishes between billable (standard of care or SOC) and non-billable costs and ensures Federal compliance in the budgeting process
• Serves as a primary resource on the business aspects of clinical research and works with study teams to develop coverage analyses and clinical trial budgets
• Creates and analyzes clinical trial financial reports and ensures financial information has been recorded accurately
• Develops integrated revenue/expense analyses, projections, reports, and presentations
• Tracks and monitors receivables and performs financial forecasting and reconciliation of internal clinical trial accounts
• Communicates financial findings to stakeholders

Senior Financial Analyst, Clinical Trials

• Responsible for the timely response to LIPs for applications and the coordination of submitted applications for either appointment or reappointment to the Medical-Dental Staff
• Assures that all credentialing procedures comply with the requirements of the Board of Registration in Medicine, the Joint Commission, the Bylaws of the Medical-Dental Staff and insurance companies
• Manages workflow of application submissions to assign files for processing by the Credentials Coordinators
• Maintains primary database for all LIP information at BMC community hospitals, overseeing the maintenance of records and participating in continuous improvement to examine processes and automation techniques to make operations more efficient
• Manages hospital privileging process for appointment/reappointment applications with Medical Executive Committee and Credentials Committee meetings, including but not limited to scheduling, preparing notices, reports, and other pertinent documents
• Prepares completed applications for approval process with Committee, including addressing clarifications and details based on anticipated inquiries during Committee process to ensure timely approval
• Facilitates the approval process through the credentialing software suite, and is responsible for follow-up with approvers and reviewers to ensure completion by proposed start dates/reappointment dates
• Leads and participates in reviews and audits by regulatory agencies or third-party payers, as appropriate
• Provides training and oversight to Credentials Coordinators, participating in performance review process with Director
• Provides backup and assistance to the Director of Medical Affairs & Credentialing, and Associate Director of Medical Affairs, as necessary
• Perform other duties to serve the operations and function of the medical staff office as assigned

Medical Staff Affairs Operations Manager

• Provides leadership, vision and management expertise to guide daily operations of the department.
• Creates and promotes a “customer service” oriented work environment with staff to improve patient experience.
• Facilitates patient pre-registration, insurance verification and financial clearance throughout various entrance points of the hospital.
• Works with hospital clinical leadership to identify workflow modifications to increase throughput initiatives.
• Independently provides and routinely monitors business metrics on operational changes to support strategy and regularly communicates to senior management.
• Reviews statistics/metrics to determine overall staff performance and effectiveness, team performance and error rates, deficits in systems, etc.; communicates those metrics to the organization.
• Develops, under the guidance of the Director and Senior Manager, programs, policies, processes and procedures to carry out strategies for achieving short and long-term goals; reviews, updates and implements policies and procedures related to registration.
• Consistently manages all team activities so that quality registration, billing, and co-pay/coins collections are provided in an efficient and effective manner, meeting all applicable federal, state, and third-party payer guidelines and regulations.
• Responsible for effective human resource management within the Patient Access Services Department to achieve quality registration, billing, collection, financial counseling services and positive employee relations; develops and mentors employees and selects qualified employees per HR policy.
• Maintains effective and appropriate staffing as evidenced by on-going budgetary analysis and develops departmental budget within designated deadlines.
• Acts as resource person on changes in billing regulations and systems procedures and provides technical expertise in the Patient Management system.
• Communicates information to Patient Access Services leadership and operational leaders within and outside Revenue Cycle in written and verbal forms to promote understanding of operations and resolve problems.
• Ensures on-going training for employees including orientation and in-services according to hospital policy and employee and organizational needs.
• Responsible for personal professional development to ensure appropriate knowledge of systems and advances in Patient Access activities.
• Adheres to all of BMC’s RESPECT behavioral standards.

Patient Access Services Supervisor – Pre-Registration and Financial Clearance

• Lead and advance all aspects of vascular imaging operations at Boston Medical Center’s Brighton campus and affiliated outpatient locations
• Oversee day-to-day multisite clinical operations across 4 vascular offices including inpatient, outpatient, sterile-procedure, and OR workflows
• Define, develop and execute strategic planning goals for vascular service line including growth, quality, revenue and patient outcomes
• Budget planning, financial performance monitoring and resource allocation; vendor and equipment procurement/negotiations
• Develop policies for vascular testing, reporting and workflow efficiency and create staffing models and scheduling strategies
• Build and maintain referral networks and collaborate with community health programs for vascular disease prevention/screening
• Lead build-out of registered vascular technologist program and vein center at Brighton and scale model across system locations
• Serve as lead vascular technologist and primary point of contact for diagnostic vascular exams; establish diagnostic criteria and reporting standards
• Develop training curriculum, mentor and supervise vascular technologists, residents, fellows, and students; handle recruitment and onboarding
• Troubleshoot protocol, schedule, and equipment issues; maintain deep knowledge of all vascular studies and mentor staff technologists
• Oversee accreditation processes and compliance with CMS, Joint Commission and hospital/state regulations; conduct QA reviews and audits
• Provide feedback and corrective action plans to Chair of Surgery and Department Administrator; represent vascular surgery lab at hospital council meetings
• Participate in growing venous treatment practice through operational planning and patient flow optimization; contribute to research and publications

Technical Manager, Vascular Ultrasound

• Lead a team of supervisors and approximately 100 FTEs within BMC’s Patient Service Center, coordinating all financial clearance activities.
• Manage three functions: Pre-registration, coordinating PCP Referrals, and obtaining Authorizations.
• Coordinate resources and activities of teams to ensure department meets productivity and quality goals; perform trend analysis and produce managerial and executive level reports.
• Collaborate with revenue cycle and clinic leadership to ensure patient access to BMC services, reduce denials, and maximize revenue.
• Ensure adherence to compliance and regulatory policies, coordination of benefits across primary payers, and managing people, processes and technology applicable to Revenue Cycle financial clearance activities.
• Implement Patient Access Services operations processes and provide system-wide oversight of services facilitating patient access to outpatient services.
• Ensure teams maintain throughput and productivity standards for financially clearing encounters between 14 days and 24 hours before the clinic date.
• Act as a resource for clinic staff regarding registration, insurance eligibility, authorizations, and documentation guidelines.
• Develop training programs related to Epic Registration and Insurance modules and activities.
• Coordinate with executive leadership to align revenue cycle access programs with Boston Medical Center’s strategic plan.
• Collaborate with other revenue cycle departments and clinic leaders to improve systems, minimize billing issues, prevent denials, increase cash, and support compliance.
• Partner with IT, Ambulatory Administration, Human Resources, Marketing, Quality and other departments; interface with external entities such as regulators, payers, vendors, other Healthcare institutions, patients and families.
• Conduct Denial Analysis to report on common themes and determine team effectiveness.
• Responsible for fiscal management of departmental operations; involved in interviewing, hiring decisions and training/orientation for staff.

Patient Access Manager

Community Manager

• Initiates face to face contact with eligible patients to describe role, explain participation benefits and begin screening process
• Schedules and completes initial hospital, clinic, or community-based visit screening, care plan, and follow up visits and phone calls
• Teaches key educational messages using culturally, linguistically and educationally appropriate strategies
• Clearly documents all activities in the patient’s record and care management system
• Participates in community outreach, presentations to community organizations, development of materials, and phone calls
• Works with patients and providers to set goals and provides guidance to achieve those goals
• Reinforces educational messages regarding disease self-management by linking clients with supportive community services and programs
• Presents patients at case review meetings and consults with Nurse Care Manager, clinical staff, behavioral health teams and PCP
• Functions within an interdisciplinary team connecting the patient with resources as needed
• Records and monitors participants’ progress toward goals within specific timeframes and documents assessments in Epic system
• Prepares reports and documents as needed or requested
• Assists patients with organizing records, making follow-up appointments, attending appointments, and filling prescriptions
• Helps patients fill out applications for Medical Assistance, Housing, and SNAP
• Provides advocacy, patient education and warm hand offs to community-based and hospital-based programs
• Assists patients in addressing barriers to concrete supports (healthcare, behavioral health, financial assistance, child-care, housing, utilities, food, entitlements, clothing, transportation, violence prevention, social isolation)
• Coordinates with community-based long-term services and supports and may visit patients in hospital and ER to facilitate transitions of care
• Provides intensive home and community-based outreach, motivational interviewing, goal setting, resource connection and accompaniment to medical appointments as needed
• Establishes culturally appropriate and trusting relationships with patients and families
• Participates in training, supervision and program meetings; develops and maintains strong relationships with community resources
• NOTE: The CWA will not provide hands on care or other home health services (performance assessments, provision of care, treatment, counseling, or monitoring of patient’s health status)

Community Wellness Advocate

Program Manager

• Administer, operate, and develop emergency management programs across the Boston Medical Center Health System (BMCHS).
• Lead interdisciplinary teams to execute integrated emergency management planning, training, and exercises.
• Author operational-level emergency response plans and tactical procedures for enterprise resilience; maintain Hazard Vulnerability Analyses (HVA), Emergency Operations Plan (EOP), and Annexes.
• Ensure regulatory compliance with Joint Commission, CARF, CMS, MEMA, COBTH, FEMA, DHS, and other agencies.
• Coordinate and oversee procurement, maintenance, and deployment of emergency management equipment.
• Assist in management of grant-funded programs including financial planning, compliance reporting, and proposal development.
• Serve as a key emergency management leader during incidents, disasters, and activations; represent BMC at city, state, and federal emergency management meetings and regulatory audits.
• Supervise, mentor, and manage emergency management staff, graduate interns, and residents; conduct staff training, after-action reports, and incident action reports.
• Manage data collection, documentation, and reporting related to emergency preparedness initiatives; manage Alertmedia and Send Word Now platforms.
• Facilitate weekly staff meetings and BMCHS Emergency Management Committee meetings; coordinate collaborative meetings among various facilities.

Emergency Management Program Manager

Clinical Research

• Treat-to-Target Serum Urate versus Treat-to-Avoid Symptoms in Gout Trial (TRUST trial) research coordination (gout study)
• 30-50% effort for a minimum of 2-3 years; grant funded through 7/2027
• Identify potentially eligible patients via patient lists and electronic medical record
• Conduct telephone interviews and screen/enroll participants, including obtaining informed consent
• Schedule patients for study visits and perform study-specific data collection and documentation
• Collect, organize, and review patient data for quality and completeness
• Perform clinical tests as required after appropriate training (Phlebotomy)
• Coordinate collection, processing, organization, and storage of biological specimens
• Assist with IRB/regulatory submissions, audits, and quality control; maintain regulatory files
• Maintain communications with research coordinator and PIs; adhere to GCP and SOPs
• Perform administrative duties including mailings, inventory/supply ordering, and equipment setup/monitoring