Clinical Pathways Manager
Remote Role with 20% Travel
Salary: Up to $115,000 DOE + 15% Bonus

Position Overview

We are seeking a dynamic and experienced Clinical Pathways Manager to lead and optimize revenue cycle management (RCM) initiatives across our multi-physician, multi-location ophthalmology and retina practice. This fully remote role with approximately 20% travel offers an exciting opportunity to influence clinical and financial outcomes in a growing, specialized healthcare organization.

Reporting directly to the Vice President of Revenue Cycle Management, the Clinical Pathways Manager will be responsible for developing, implementing, and refining clinical pathways that align with best practices, enhance patient outcomes, and drive financial performance. This role requires a strategic thinker with a deep understanding of ophthalmology and retina-specific coding, billing, and reimbursement processes.


Key Responsibilities

Revenue Cycle Optimization:
Lead and manage RCM initiatives across multiple practice locations, ensuring accurate and timely billing, coding, and reimbursement for ophthalmology and retina services.

Clinical Pathway Development:
Collaborate with clinical and administrative teams to design and implement evidence-based clinical pathways that standardize care, improve patient outcomes, and enhance operational efficiency.

Stakeholder Collaboration:
Work closely with physicians, practice leaders, and other departments to ensure alignment of clinical pathways with organizational goals and regulatory requirements.

Performance Monitoring:
Establish and monitor key performance indicators (KPIs) related to clinical pathways and revenue cycle processes, using data to drive continuous improvement.

Compliance and Education:
Ensure adherence to federal, state, and payer-specific regulations, providing training and support to staff on clinical pathway protocols and RCM best practices.

Process Improvement:
Identify opportunities for process enhancements within the revenue cycle and clinical pathways, leading initiatives to streamline workflows and reduce inefficiencies.

Reporting and Analysis:
Prepare and present regular reports on clinical pathway performance, financial metrics, and project milestones to senior leadership.


Qualifications

Experience:
Minimum of five (5) years in a revenue cycle leadership position within an ophthalmology or retina practice, with a proven track record of managing RCM operations and implementing clinical pathways.

Education:
Bachelor's degree in Healthcare Administration, Business Administration, or a related field. Advanced certifications (e.g.,
Certified Professional Coder (CPC)) are preferred.

Technical Skills:
Proficiency in ophthalmology-specific electronic health record (EHR) and practice management (PM) systems. Familiarity with coding and billing software relevant to ophthalmology and retina care.

Analytical Abilities:
Strong analytical skills with the ability to interpret complex data, identify trends, and implement data-driven solutions.

Communication:
Excellent verbal and written communication skills, with the ability to effectively collaborate with diverse teams and stakeholders.

Travel Requirements:
Willingness to travel approximately 20% for on-site visits, training, and meetings.


Compensation and Benefits

Salary:
Competitive base salary up to $115,000, commensurate with experience.

Bonus:
Eligibility for an annual performance-based bonus of up to 15%.

Benefits:
Comprehensive benefits package.


Why Join Us?

This is a unique opportunity to play a pivotal role in shaping the future of clinical care and financial performance in a leading
ophthalmology and retina practice. As a remote Clinical Pathways Manager, you will have the flexibility to work from home while contributing to the success of a dynamic and growing organization.

If you are a strategic leader with a passion for optimizing clinical pathways and revenue cycle processes, we invite you to apply and be part of our innovative team.