DescriptionAt ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.
Job Summary
The Application Analyst Consultant, Revenue Cycle serves as an enterprise-level subject matter expert and technical-functional consultant for revenue cycle applications, platform strategy, and technology-enabled performance improvement. This role provides advanced guidance in the planning, design, implementation, optimization, and lifecycle management of highly complex revenue cycle systems and solutions across the organization. The Consulting Analyst partners with Revenue Cycle Operations, Finance, Compliance, Information Technology, vendors, and executive stakeholders to ensure system capabilities support organizational objectives, regulatory requirements, financial performance, operational consistency, and long-term scalability.
Essential Functions
- Provide enterprise-level consulting, technical leadership, and functional guidance for highly complex revenue cycle application solutions, platform strategy, optimization, and lifecycle management.
- Serve as a trusted advisor to Revenue Cycle, Finance, Compliance, IT, and executive leadership on system strategy, optimization opportunities, regulatory impacts, vendor capabilities, and technology-enabled performance improvement.
- Translate business strategy, executive priorities, regulatory requirements, and operational needs into scalable, sustainable application solutions that support enterprise financial and operational goals.
- Lead or oversee multiple enterprise revenue cycle initiatives, including implementations, upgrades, integrations, workflow redesigns, payer initiatives, regulatory changes, and optimization programs.
- Ensure projects and initiatives are clearly defined, systematically executed, aligned with ScionHealth methodologies and change management standards, and focused on measurable business results.
- Define project scope, timelines, success metrics, risk mitigation strategies, testing approaches, and operational readiness plans for complex initiatives.
- Provide strategic oversight and ownership of revenue cycle application architecture, configuration standards, build governance, documentation standards, and lifecycle management practices.
- Establish and maintain frameworks for consistent application build, controlled change management, data integrity, system controls, and alignment with enterprise policies and regulatory requirements.
- Analyze highly complex revenue cycle workflows, system configurations, payer requirements, regulatory changes, and financial performance data to identify opportunities to improve revenue capture, reimbursement, denial prevention, A/R resolution, compliance, and operational efficiency.
- Advise, oversee, and support project teams in analyzing business requirements, evaluating feasible system and technical alternatives, documenting solution designs, and validating that solutions meet business needs.
- Direct and coordinate work of internal team members, vendors, and consulting resources as they collect, document, analyze, configure, test, validate, and implement system solutions.
- Lead development and governance of dashboards, reports, data extracts, and performance metrics that provide visibility into revenue cycle outcomes and support leadership decision-making.
- Ensure data integrity and alignment across revenue cycle applications, reporting platforms, clearinghouses, payer systems, and downstream financial systems.
- Prepare and conduct formal presentations for leadership regarding major initiatives, business impacts, risks, recommendations, new technology directions, vendor roadmaps, and regulatory changes.
- Provide expert-level support for escalated application, workflow, integration, reporting, EDI, payer, and reimbursement issues; use problem management and root cause analysis techniques to recommend and implement corrective actions.
- Partner with vendors and internal teams to evaluate product roadmaps, resolve complex issues, assess new functionality, and ensure application capabilities align with organizational strategy.
- Serve as coach, mentor, and advisor to less senior analysts and project team members; provide direction and education on application standards, revenue cycle workflows, documentation expectations, and best practices.
- Participate in candidate interviews, hiring recommendations, team development, and other departmental leadership activities as requested by management.
- Maintain current knowledge of healthcare revenue cycle regulations, payer requirements, application capabilities, industry trends, and ScionHealth Information Technology standards to support department success and professional growth.
Knowledge/Skills/Abilities/Expectations
- Expert knowledge of the revenue cycle business area and the enterprise applications, workflows, integrations, data, and controls that support it.
- Highest level of functional and technical knowledge of revenue cycle applications, business applications, reporting tools, application architecture, testing methodologies, data validation, and system implementation practices related to the area supported.
- Ability to work independently, lead enterprise projects with minimal supervision, and provide consulting-level guidance in ambiguous or highly complex situations.
- Ability to understand ScionHealth’s Information Systems strategy and business strategy and translate both into practical revenue cycle technology solutions.
- Advanced ability to facilitate cross-functional decision-making, influence without direct authority, resolve competing priorities, and communicate recommendations to operational, technical, and executive audiences.
- Competent in the use of industry standard project management methodologies, system development lifecycle practices, change management processes, testing approaches, and documentation standards.
- Strong healthcare experience preferred; revenue cycle, reimbursement, payer operations, or revenue integrity experience strongly preferred.
QualificationsEducation
- Bachelor’s Degree Degree in Information Systems, Healthcare Administration, Business, Finance, Health Information Management, or related field (Required)
- Master’s Degree Degree in Information Systems, Healthcare Administration, Business, Finance, Health Information Management, or related field (Preferred)
- Equivalent Combination of Education and Experience experience in information systems, healthcare revenue cycle, or related field (May be Considered)
Licenses/Certifications
- Current application, revenue cycle, project management, or technical certifications, such as Epic, MEDITECH, HFMA/CRCR, PMP, ITIL, SQL/reporting, or other relevant certifications (Preferred)
- Expert knowledge of end-to-end healthcare revenue cycle workflows, including patient access, charge capture, coding, billing, claims, denials, remittance, collections, payer operations, reimbursement, and revenue integrity. Required
- Advanced experience with enterprise RCM platforms, EHR revenue cycle modules, clearinghouses, payer rules, EDI transactions, reporting tools, and downstream financial systems. Required
- Strong understanding of CMS, Medicare, Medicaid, commercial payer requirements, HIPAA, regulatory compliance, and healthcare reimbursement methodologies. Required
- Advanced analytical, presentation, facilitation, documentation, and executive communication skills required. Required
Experience
- 10+ years progressive experience in Information Technology, healthcare revenue cycle systems, revenue cycle operations, or related healthcare business applications (Required)
- 7-9 years of experience working in the core functional or technical area supported by the role, including enterprise revenue cycle platforms, EHR/RCM applications, application build/configuration, workflow design, reporting, integration, or payer/regulatory support (Required)
- 2+ years leading and coordinating multi-department, enterprise-scale application initiatives, implementations, integrations, optimization programs, or complex revenue cycle technology projects (Required)
- Prior Experience advising leadership, translating business strategy into technology solutions, and leading cross-functional teams through complex business, technical, regulatory, or operational change (Required)
- Prior Experience supporting multi-entity, multi-facility, or health system-level revenue cycle operations (Required)
Additional Qualifications Clarification
- Expert knowledge of end-to-end healthcare revenue cycle workflows, including patient access, charge capture, coding, billing, claims, denials, remittance, collections, payer operations, reimbursement, and revenue integrity. (Required proficiency)
- Advanced experience with enterprise RCM platforms, EHR revenue cycle modules, clearinghouses, payer rules, EDI transactions, reporting tools, and downstream financial systems. (Required proficiency)
- Strong understanding of CMS, Medicare, Medicaid, commercial payer requirements, HIPAA, regulatory compliance, and healthcare reimbursement methodologies. (Required proficiency)
- Advanced analytical, presentation, facilitation, documentation, and executive communication skills required. (Required proficiency)