Clinical Success Program Manager Ambulatory Billing Revenue (Hybrid - Troy, MI) - Populance

GENERAL SUMMARY:

This Clinical Success Program Manager will report to the Director, Ambulatory Case Management and work closely with program development, product, tech, and analytics teams, as well as other departments including revenue cycle and the Clinically Integrated Network (CIN). This role will be responsible for effectively addressing gaps and identifying opportunities to optimize revenue generation and quality reporting.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

• Assist clinical success leadership team to lead the planning, execution, and continuous improvement of population health programs to enhance efficiency and clinical outcomes.
• Partners with other clinical success leaders (directors, managers) as part of multidisciplinary teams to ensure program goals and outcomes are achieved.
• Serve as the primary project manager for clinical success initiatives, helping clinical success leaders overseeing timelines, scope, budgets, and resource allocation.
• Align and integrate new and existing programs by mapping workflows, coordinating onboarding, and ensuring operational readiness.
• Collaborate with analytics teams to define KPIs, monitor performance, and translate insights into actionable improvements.
• Coordinate cross-functional teams-including care coordination, IT, analytics, and business operations-to ensure seamless program delivery.
• Facilitate project meetings, maintain documentation (e.g., Gantt charts, schedules), and provide regular status updates to stakeholders.
• Identify and mitigate risks, resolve barriers, and adapt plans to meet evolving program needs.
• Drive innovation and efficiency through data analysis, stakeholder feedback, and strategic planning.
• Support partnerships with internal and external stakeholders (e.g., Henry Ford Health, Mosaic CIN, HAP, potential new customers) to implement care pathways and education initiatives.
• Lead the development of program charters, performance metrics, and reporting tools to support organizational goals.
• Help clinical success leaders champion change management and foster alignment across multidisciplinary teams to ensure program success.
• Allocate approximately 50% of time to project management, flexing based on weekly priorities and program needs.
• Facilitate integration of new customers by mapping workflows, aligning clinical and technical processes, and supporting onboarding activities.
• Identify opportunities for program innovation and efficiency through data analysis and stakeholder feedback.
• Works closely with all relevant stakeholders to set program goals, clearly define operational dependencies, develop appropriate performance standards, metrics and reporting tools required for successful program design.
• Demonstrate the ability to deal with the changing environment and to lead/facilitate and manage change efficiently and effectively where appropriate.
• Analyzes large data sets to identify program opportunities and provides performance updates for cross-departmental initiatives and executive oversight.
• Utilizes innovative thinking to create solutions that address challenges and fulfill project requirements and expectations.

• Other duties as assigned.

  Department Specific Duties:

  • Provide Analysis of performance reports, including the identification of errors/gaps.
  • Manage work queues related to Case Management billing.
  • Work with analytics and Helios team on optimizing documentation processes; and others as identified.
  • Audit charts for appropriate billing documentation.
  • Reconcile performance reports with internal data.
  • Audit claims reports against system reporting for accuracy.
  • Review roster reports to verify accuracy in target/metric reporting.
  • Work with system/CIN to identify and address discrepancies with PDP alignment.

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