Enterprise Denials Stratgy, Lead

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Job Summary:

We are seeking an experienced Enterprise Denials Strategy Lead to support enterprise-wide denials performance improvement initiatives across Emory Healthcare. This role plays a critical operational and strategic support function by translating denial trends, root cause analysis, and analytic insights into actionable improvement initiatives across Hospital Billing (HB), Professional Billing (PB), and cross-functional partners. The Strategy Lead partners closely with the Enterprise Denials Senior Project Manager to support execution of the enterprise denials strategy by developing well-scoped project concepts, coordinating workgroups, and managing assigned process improvement initiatives from concept through implementation. This role requires strong analytical skills, operational judgment, and the ability to collaborate effectively across diverse stakeholders to drive measurable improvements in denial performance.

Primary Duties and Responsibilities:

• Operational Strategy & Project Development Analyze denial trends, root cause analysis findings, and analytic insights to identify operational improvement opportunities.
• Develop project concepts, scopes, objectives, and success metrics based on validated data and operational priorities. Partner with the Enterprise Denials Senior Project Manager to prioritize initiatives and align projects with enterprise denials strategy.
• Translate analytic findings into clear problem statements, proposed solutions, and measurable outcomes.
• Process Improvement & Project Execution Lead assigned process improvement initiatives using structured project management principles.
• Coordinate cross-functional workgroups and stakeholders to support project execution, issue resolution, and timeline adherence.
• Track milestones, risks, dependencies, and outcomes for assigned initiatives.
• Support implementation of workflow changes across Access, CPD, HIM, Coding, Billing, and clinical departments.
• Operational Meetings & Workgroup Support Support Enterprise Denials operational meetings by preparing materials, data summaries, and discussion points.
• Facilitate assigned workgroups or breakout sessions focused on specific denial drivers or improvement initiatives.
• Document decisions, action items, and follow-up tasks to ensure accountability and progress.
• Escalate risks, barriers, and decision points to the Enterprise Denials Senior Project Manager in a timely manner. Analytics & Data Collaboration Partner with analytics teams and the Senior Manager of Analytics to review and interpret denial data and RCA outputs.
• Validate data trends prior to operational use and project development.
• Support development of standardized, action-oriented data summaries for operational partners.
• Ensure project metrics align with enterprise reporting and performance measurement standards.
• Stakeholder Engagement & Communication Serve as an operational liaison between Enterprise Denials Management, operational teams, and project stakeholders.
• Communicate project status, risks, and outcomes clearly to the Enterprise Denials Senior Project Manager and relevant partners.
• Develop clear written updates, summaries, and documentation to support leadership visibility.
• Promote collaboration, transparency, and shared accountability across project teams.

Additional Duties as Assigned

• Travel Less than 10% of the time may be required.

Work Type

• Hybrid employee - splits time between working remotely and working in the office.

Minimum Required Qualifications

Education

• Bachelor's degree in healthcare, business administration, finance, analytics, or a related field or equivalent experience.

Experience

• Minimum 3-5 years of experience in revenue cycle operations, denials management, healthcare process improvement, or related operational roles.

Knowledge, Skills, and Abilities (Required)

• Working knowledge of hospital and professional billing denials and root cause analysis
• Ability to analyze data and translate findings into actionable operational initiatives
• Experience supporting or leading cross-functional operational projects
• Strong organizational skills with ability to manage multiple initiatives concurrently
• written and verbal communication skills
• Ability to collaborate effectively across departments and stakeholder groups

Preferred Qualifications

Experience

• Experience partnering with analytics or reporting teams
• Familiarity with Epic HB and PB workflows and denial logic
• Experience using reporting tools such as Power BI or Etyon

Certifications

• Lean Six Sigma, project management training, or equivalent experience preferred

Knowledge, Skills, and Abilities (Preferred)

• Advanced analytical and problem-solving skills with strong attention to detail
• Ability to facilitate workgroups and support operational decision-making
• Strong documentation and follow-through skills
• Comfort working in fast-paced, data-driven environments
• Ability to synthesize complex information into concise operational recommendations

PHYSICAL REQUIREMENTS (Medium -Max 25 lbs.) Up to 25 lbs., 0-33% of the workday (occasionally); lifting up to 25 lbs.; carrying objects up to 25 lbs.; occasional to frequent standing and walking; occasional sitting; close eye work (computers, typing, reading, writing). Physical demands may vary depending on assigned work area and tasks. ENVIRONMENTAL FACTORS Environmental conditions may vary depending on assigned work area and tasks. Exposures may include, but are not limited to: blood-borne pathogens, biohazardous waste, chemicals/gases/fumes/vapors, communicable diseases, electrical shock, floor surfaces, hot/cold temperatures, indoor/outdoor conditions, latex, lighting, patient care/handling injuries, radiation, and shift work. Travel may be required. Use of personal protective equipment may be required depending on work area and tasks.