Ensemble Health Partners

Procurement

• Conduct sourcing activity from beginning to end based on Five Pillars (Strategy, Value, Information, Performance, Relationship) of vendor management
• Provide business case upon assessment of vendor proposals with logic, tactics, and cost breakdowns
• Work cross-functionally with client delivery, operational leaders, and project managers to drive service strategy to execution in a timely manner
• Meet targets of cost reduction targets on a project or annual basis
• Maintain relationships with vendors and provide feedback of performance, relationship, and vision
• Manage issues and schedule changes of vendors and capture cost impact while leading an action plan for resolution
• Develop and implement Annual Service Category Strategy by assessing service trend or future vision, ratings of vender performance, and cost competitiveness
• Lead Annual Price Review (APR) discussion, and kaizen (continuous improvement) for assigned services to continually reduce costs
• Create and maintain cost models and playbook for services
• Actively participate in insource versus outsource discussions to benefit Ensemble
• Benchmark new vendors and support due diligence process with all relative stakeholders (IT, Finance, Compliance, Legal)

Vendor Management Sourcing Manager

IT Support

• Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or location Financial Assistance program.
• Assists with application processes to facilitate accurate and appropriate submissions.
• Follows-up on submitted applications to insure timely billing or adjustment processing.
• Reviewing all referred uninsured/under-insured patients for program eligibility opportunities, initializing and coordinating the application process to facilitate accurate and appropriate submissions.
• Effectively communicating with the patient to obtain documents that must accompany the application.
• Following submitted applications to determination point, updating applicable insurance information and ensuring timely billing or adjustment posting.
• Documenting all relevant actions and communication steps in assigned patient accounting systems.
• Maintaining working knowledge of all state and federal program requirements; shares information with colleagues and supervisors.
• Developing and maintaining proactive working relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.
• Other job duties as assigned.

Public Benefit Specialist

Project Manager

• Perform Project Management functions aligned with the PMO best practices for technology, client, vendor, strategic projects and others as needed
• Lead project teams through initiation, planning, executing/monitoring and controlling, and closing of designated projects with support from other Project Leaders in the PMO
• Ensure project work is well-defined and planned
• Ensure effective risk, issue, action, and change management
• Establish, maintain and execute an effective communications plan serving all stakeholder needs
• Monitor and manage project performance inclusive of cost and team performance
• Manage changes to the project scope, project schedule and project costs using appropriate verification techniques

Financial Planning and Analysis

• Make day-to-day leadership decisions using data-driven intelligence to drive operational excellence
• Oversee developing, implementing, and maintaining various data and analytic solutions
• Assist in setting operational priorities/objectives and responsible for tactical and strategic analytic efforts
• Inspire and sustain team unity and engagement
• Establish cross-functional partnerships to ensure analytics solutions address complex business needs

Director, Finance – Office of the CFO

Director

• Responsible for day-to-day client operations and the planning, development, and implementation of policies, objectives, and initiatives for acute or physician revenue cycle activities
• Form and nurture relationships with clients, influence and direct operations, and ensure results are consistently delivered
• Communicate organizational values and positive leadership to all associates and ensure accountability for client performance expectations
• Articulate plans with client deliverables, timelines, outcomes, and actions, and monitor bad debt and process improvements
• Identify gaps in client support or performance and propose solutions to drive improvement
• Participate and lead program-level meetings with stakeholders, working closely with CFO and client leadership to support analysis, reporting, and service line development
• Act as a revenue cycle expert, ensuring prompt communication of changes related to payer policies, contracting, regulatory updates, and compliance requirements
• Assist client leadership in understanding revenue cycle processes, metrics, tools, and reports
• Facilitate monthly client meetings to review operations performance, strategic initiatives, partnership opportunities, and escalated support needs

Director, Partnership Success

Bilingual

• Scheduling and pre-registering patients for the appropriate procedures based on physician's orders
• Selecting accurate medical records for patient safety
• Providing proper patient instructions
• Pre-registering patients, obtaining and validating demographic and insurance information
• Point of Service collections and financial counseling functions as appropriate
• Other job related duties as required by their supervisor, subject to reasonable accommodation

Bilingual Scheduling Specialist

Customer Support

• Provides support for all denial and audit activities across the Mercy Health ministry.
• Processing and preparation of outgoing mail and data entry.
• Meeting regulatory compliance requirements.
• Performs other duties as assigned.

Associate Denials Support Specialist

Vice President

• Lead enterprise-level operational innovation strategy
• Identify opportunities to redesign processes and improve operational workflows
• Partner closely with Product, Technology, Data Science, and Operations leaders
• Serve as an internal consultant and thought partner to executive and client leadership
• Pilot, test, and scale new operational models, tools, and methodologies
• Establish success metrics, track outcomes, and communicate results

AVP, Operational Innovation

Engineer

• Design, deploy, configure, and maintain Five9 Contact Center solutions to meet business requirements.
• Collaborate with cross-functional teams to gather telephony-related requirements and provide technical expertise during solution design and implementation phases.
• Perform system upgrades, patches, and updates for all telephony platforms to ensure optimal performance, security, and compliance.
• Study, analyze and understand business requirements in context to business intelligence, design and map data models to shift raw data into meaningful insights.
• Proactively identify areas for improvement and propose enhancements to enhance system performance, scalability, and reliability.
• Utilize Power BI to build interactive and visually appealing dashboards and reports, with key performance indicators.
• Analyze previous and present data for better decision making, building multi-dimensional data models.
• Conduct regular system audits and performance assessments, producing reports and recommendations for continuous improvements.
• Develop strong data documentation about algorithms, parameters, models, perform detailed analysis on tested and deployed Power BI scripts, DAX queries and functions in Power BI.
• Participate in on-call rotations to provide after-hours support for critical incidents or emergencies.
• Stay up-to-date with industry trends and best practices in telephony, contact center technologies, and communication protocols.
• Hands-on experience in report and dashboard development in Power BI, Tableau, and SAP.
• Familiarity with SQL querying for data manipulation and knowledge of data warehouse concepts.

Senior Engineer, Telephony

• Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or Financial Assistance program.
• Assists with application processes to facilitate accurate and appropriate submissions.
• Follows-up on submitted applications to ensure timely billing or adjustment processing.
• Reviewing all referred uninsured/under-insured patients for program eligibility opportunities, initializing and coordinating the application process to facilitate accurate submissions.
• Effectively communicating with the patient to obtain documents that must accompany the application.
• Following submitted applications to determination point, updating applicable insurance information and ensuring timely billing or adjustment posting.
• Documenting all relevant actions and communication steps in assigned patient accounting systems.
• Maintaining working knowledge of all state and federal program requirements; shares information with colleagues and supervisors.
• Developing and maintaining proactive working relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.
• Other job duties as assigned.

Strategy

• Lead the planning, development, and execution of strategic projects to ensure alignment with organizational goals and objectives.
• Demonstrate executive presence by effectively communicating with senior leadership, presenting strategic initiatives, and influencing decision-making at the highest levels.
• Oversee the implementation of technology initiatives that enhance operational efficiency, improve service delivery, and drive innovation.
• Manage project timelines, budgets, and resources to ensure projects are delivered on time and within scope.
• Collaborate with cross-functional teams, including IT, operations, and business units, to ensure successful project outcomes.
• Identify opportunities for process improvements and implement best practices to enhance project delivery and organizational performance.
• Assess and mitigate risks associated with strategic projects, ensuring compliance with regulatory requirements and organizational standards.
• Develop and monitor key performance indicators (KPIs) to track project progress and measure success.
• Mentor and develop team members, fostering a culture of excellence and continuous learning.
• Manage vendor relationships and oversee contracting processes to ensure successful partnerships and project outcomes.

AVP, Operational Strategic Initiatives

• Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or Financial Assistance program.
• Assists with application processes to facilitate accurate and appropriate submissions.
• Follows-up on submitted applications to ensure timely billing or adjustment processing.
• Reviewing all referred uninsured/under-insured patients for program eligibility opportunities, initializing and coordinating the application process to facilitate accurate and appropriate submissions.
• Effectively communicating with the patient to obtain documents that must accompany the application.
• Following submitted applications to determination point, updating applicable insurance information and ensuring timely billing or adjustment posting.
• Documenting all relevant actions and communication steps in assigned patient accounting systems.
• Maintaining working knowledge of all state and federal program requirements; shares information with colleagues and supervisors.
• Developing and maintaining proactive working relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.

Medical writer

• Completes initial patient medical record review within 24-48 hours of patient's admission; completes subsequent reviews of patient's medical record reviews every 24-48 hours and enters review findings in CDE software system
• Assigns Principal diagnosis, CC/MCC (complication and comorbidity/major complication and comorbidity), evaluate for Severity of Illness (SOI) and Risk of Mortality (ROM) on all patients while in-house.
• Assigns working ICD-10-CM and PCS codes and DRG (Diagnosis Related Group) using encoder in CDE software.
• Clarifies with physicians regarding missing, unclear, unsupported or conflicting health record documentation by requesting and obtaining additional documentation from physicians when needed.
• Educates key healthcare providers such as physicians, nurse practitioners, allied health professionals, nursing and care coordination regarding clinical documentation improvement, documentation guidelines and the need for accurate and complete documentation in the health record.
• Partners with coding professionals to ensure accuracy of diagnostic and procedural data and completeness of supporting documentation to determine the working and final DRG assignment.
• Reviews DRG denial letters and writes denial appeal letters.
• Collaborates with care coordination, nursing staff and other ancillary staff regarding interaction with physicians on documentation and to resolve physician clarifications prior to patient discharge.
• Maintains and upholds all clinical documentation regulatory guidelines.
• Formulates and submits timely, well prepared appeals for reconsideration by third party administrators (payors). Including supporting documented clinical evidence, Coding/CDE Guidelines and other regulatory standards/guidelines as appropriate.
• Works collaboratively with co-works and management to effectively resolve root cause issues that impact payor contracts, hospital operations, or departmental to maintain reimbursement and minimize appeal requests and/or denials.

RN Clinical Documentation Integrity

Program Manager

• Develop and implement comprehensive social media strategies to enhance brand visibility and engagement.
• Manage and oversee all social media channels, including content creation, scheduling, and community management.
• Monitor social media trends and adjust strategies as needed to stay current and effective.
• Manage strategy and execution to strengthen profiles for key Ensemble executives and stakeholders.
• Collaborate with the marketing team to create and execute content marketing plans that align with overall business goals.
• Track and analyze the performance of social media and content marketing campaigns using relevant metrics and tools.
• Assist the Director of Marketing Communications in executing PR strategies and campaigns.

Marketing Communications Program Manager

Counselor

• Perform the task of benefit education and validation
• Handle accurate verification and calculation of patient liabilities
• Work within the policies and processes performed across the organization
• Assess and collect patient liabilities including copays, deductibles, and co-insurance

Vendor Management Sourcing Manager

Public Benefit Specialist

Project Manager

Director, Finance – Office of the CFO

Director, Partnership Success

Bilingual Scheduling Specialist

Associate Denials Support Specialist

AVP, Operational Innovation

Senior Engineer, Telephony

Public Benefit Specialist

AVP, Operational Strategic Initiatives

Public Benefit Specialist

RN Clinical Documentation Integrity

Marketing Communications Program Manager

Financial Counseling Specialist