The Denials Prevention and Mitigation Manager collaborates with senior leaders and key stakeholders or experts to develop system-wide responses to the Denials Prevention and Mitigation issues that impact the Revenue Integrity department. This position also collaborates with the Revenue Integrity Director to operationalize Phoenix Children’s Denials Prevention and Mitigation strategy and plan for improving revenue results across all revenue operations in all departments, financial processes, functions and interdependencies. It is the responsibility of the Denials Prevention and Mitigation Manager to lead, coordinate, monitor, maintain, update, and analyze denial trends, and to optimize revenue generation through continuous improvement and sustainability.

• Plans and prioritizes efforts of the Denials Prevention and Mitigation Team to maximize impact. Leverages and continuously refines a prioritization model based on both data and subject matter expert input. Efforts may include any/ all system sites, across all potential denial departments/ business lines, and in partnership with any/ all payers.
  
• Leads efforts prioritized to completion through leveraging enterprise-wide subject matter experts, generating innovative and sustainable solutions, and implementing through build to completion. Integrate solutions within existing work flows and technology systems to have hardwired solutions whenever possible.
  
• Supports the initiatives of the Denials Prevention and Mitigation Program, focusing on denials prevention activities and performance improvement.
  
• Controls or sustains results across all sites of the system, through dynamic reporting. Organizes reports out of results achieved on at minimum a monthly basis to revenue leadership.
  
• Provides one-off reporting as needed to gain executive insights and support system awareness.
  
• Monitors healthcare trends and maintains knowledge of denials.
  
• Monitors and trends Key Performance Indicators (KPIs) to identify new Denials Prevention and Mitigation initiatives, tracks performance improvement activities, and documents improved performance for the Director.
  
• Provides focused education to clinical and coding stakeholders as well as feedback process.
  
• Provides evaluation, reports, and advice as well as improvement recommendations to management in all service lines.
  
• Leads root cause analysis investigations resulting from denial trends and reason codes.
  
• Performs miscellaneous job related duties as requested.
  

To advance hope, healing and the best healthcare for children and their families

Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

• Offering the most comprehensive care across ages, communities and specialties
• Investing in innovative research, including emerging treatments, tools and technologies
• Advancing education and training to shape the next generation of clinical leaders
• Advocating for the health and well-being of children and families

• We place children and families at the center of all we do
• We deliver exceptional care, every day and in every way
• We collaborate with colleagues, partners and communities to amplify our impact
• We set the standards of pediatric healthcare today, and innovate for the future
• We are accountable for making the highest quality care accessible and affordable