Emerus Holdings, Inc.

Clinical Operations

• Coordinate assigned projects from initiation through completion, delivering both on-time and within budget
• Be the point of contact and coordinate all departments necessary for the projects
• Manage resources with peers and functional managers
• Identify and manage project risks and issues
• Report on project budgets
• Provide frequent project status to management and project teams
• Create long- and short-term plans, setting targets for milestones and adhering to deadlines
• Develop and manage Activation and Operations Readiness plans for new hospital openings

Clinical Project Manager

Compliance

• Develop, implement, and continuously improve the compliance program, policies, and procedures; align to OIG/CMS expectations and industry best practices.
• Establish and maintain an enterprise risk management approach that identifies, assesses, mitigates, and monitors key risks (clinical, operational, financial, regulatory, and reputational).
• Assist with federal/state surveys, audits, and oversight activities.
• Oversee intake, triage, and investigation of hotline reports, complaints, and potential violations; ensure consistent documentation, confidentiality, root cause analysis, and corrective action.
• Partner with Privacy and Information Security leaders on HIPAA/privacy incident management, breach risk assessments, mitigation plans, and required notifications.
• Build and manage a risk-based annual work plan; oversee auditing and monitoring activities (e.g., EMTALA, billing/claims, documentation, patient rights, conflicts of interest) and track trends and outcomes.
• Drive development, implementation, and verification of corrective action plans; define owners, milestones, and effectiveness measures.
• Design and oversee compliance and risk training; promote speak-up culture, non-retaliation, and operational integration of compliance requirements.
• Prepare and present compliance/risk metrics, significant matters, and program updates to executive leadership, committees, and Boards; advise on risk tolerance and escalation decisions.
• Oversee development, review, and maintenance of compliance and risk-related policies, standards, and guidance; ensure policies are operationalized and accessible.
• Collaborate on third-party due diligence and contracting controls impacting compliance, privacy, and security obligations.
• In partnership with Legal and Risk, coordinate intake and tracking of litigation matters impacting the organization; support document retention and legal holds, discovery readiness, and collection of records; monitor trends, reserves/exposure (as appropriate), and remediation actions to reduce future risk.
• Partner with Legal, Quality/Patient Safety, and insurance partners on claim trends, event investigations, and risk mitigation strategies (as applicable to the organization).
• Recruit, develop, and lead a high-performing team; establish goals, performance expectations, and a continuous improvement mindset.

Vice President, Compliance & Risk Management

Systems Engineer

• Develop architecture, execute projects, and troubleshoot server hardware & software, system applications, and data processing
• Primary contact for data center infrastructure, cloud service, and server operations including provisioning, maintenance, backup & recovery
• Acts as a strategic advisor to IT Infrastructure leadership
• Manage computer servers, network health, file backups, antivirus and EDR servers
• Perform maintenance windows, testing, disaster recovery planning or unplanned outages
• Oversee email service including administration and provisioning of mailboxes, calendars and distribution lists
• Document system configurations and track changes
• Provide mentorship and technical leadership to system administrators and support staff
• Serve as escalation point for System administrators, Desktop and Helpdesk analysts

Senior Systems Engineer

Medical Billing and Coding

• Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and CPT-4 to include IV infusion and injection codes
• Review clinical documentation and diagnostic results to extract data and apply HCPCS and facility level Evaluation & Management codes for billing
• Abstract and code diagnoses and procedures from health records by using appropriate classification systems
• Attend staff meetings or other company sponsored or mandated meetings as required
• Perform additional duties as assigned
• Ability to work off hours and overtime

Medical Coding Specialist – ER, Facilities

Data Analyst

• Serve as the managed care liaison and subject matter expert for joint venture hospital partners, revenue cycle billing and collections teams, and finance department leaders.
• Compile and analyze payer performance metrics for reporting to organizational leadership.
• Maintains up-to-date managed care contract databases to streamline collections, support analysis, and share contract terms efficiently.
• Assist the revenue cycle team by loading and maintaining current payer rates in an insured allowed/payment validation module.
• Perform random audits of claim payments to ensure payer compliance with managed care agreements.
• Support special projects, including claim data analysis for contract negotiations, service line research, and pro formas for new market opportunities.
• Build contract models to assess current performance yields and evaluate new contract proposals.
• Collaborate with the revenue cycle team to identify underpaid/overpaid claims and develop initiatives to secure accurate payments.
• Provide managed care insights and contract modeling (e.g., rate escalators, charge master updates, new contract yields) to support the finance team’s annual budget process.
• Aid the revenue recognition team during month-end close by offering managed care perspectives on key revenue-influencing items.
• Ensure compliance with federal and state price transparency regulations by preparing and maintaining required files.
• Represent managed care in joint venture board meetings or monthly operational reviews as required.
• Conduct financial data analysis and respond to internal/external inquiries from management.

Clinical Project Manager

Vice President, Compliance & Risk Management

Senior Systems Engineer

Medical Coding Specialist – ER, Facilities

Senior Managed Care Contract and Data Analyst