Position Summary...

What you'll do...

Walmart Health is seeking a new manager of billing and revenue cycle with leadership experience and a proven track record of exceeding expectations. The manager of billing and revenue cycle will be responsible for identifying, evaluating, and resolving billing trends associated with Walmart Health. In addition, the manager will be responsible for working with our billing vendors to meet and exceed our billing goals and initiatives. Our ideal candidate would have Epic experience, strong analytical skills, and an effective communicator.

Researches complex bill review data to identify trends and implement best practices by

• running and analyzing reports
• determining root causes of increased charges or payment allowances
• determining solutions to negative trends
• maximizing benefits of positive trends (for example, applying cost savings across multiple states)
• evaluating performance metrics (for example, reconsideration logs, savings dashboard)
• partnering with other teams (for example, analytics, senior coordinators, case managers, medical providers, defense counsel, regulatory agencies)
• developing and maintaining workflow processes to ensure accurate implementation.

Ensures compliance with laws and regulations by

• researching changes to federal, state, and local laws and regulations impacting insurance payment of medical bills
• ensuring changes in state reporting requirements, periodic fee schedules, and applicable laws and regulations are applied to bill review process and procedures
• evaluating auditing results to ensure the audit forms measure the desired quality results
• modifying the auditing process as regulatory agency requirements change
• building and maintaining relationships with other bill processing teams, state agencies, the Legal department, and bill review suppliers to clarify regulations or implement systematic changes required for compliance
• evaluating vendor processors quality audit results, providing feedback on results to vendor processors, and creating action plans to correct deficiencies
• ensuring regulatory certifications for state and federal utilization and bill review are obtained.

Manages vendor contracts by

• holding vendors accountable for delivering contracted services
• ensuring contract language meets business and compliance requirements
• monitoring workflow and changing it to meet vendor requirements to obtain discounted services
• ensuring claims team complies with contract requirements.

Serves as subject matter expert by

• educating internal teams about bill review process and system changes
• providing supporting information and education related to litigation of bill review to defense counsel
• analyzing bill review litigation trends with adjusting teams and Legal department to develop solutions for implementation
• collaborating with third party administrators to improve processes
• drafting letters and developing explanation of review statements for multiple states
• educating team and vendor processors on pre-litigation best practices
• participating and leading special projects to enhance bill payment processes.

Manages customer service and vendor call centers by

• reviewing reports on call time averages to make sure calls are processed efficiently and effectively
• ensuring responses to inquiries regarding pharmacy and medical billing from internal and external stakeholders
• identifying and resolving global trends on escalated issues (for example, unprocessed hospital bill complaints).

Coordinates, completes, and oversees job-related activities and assignments by

• developing and maintaining relationships with key stakeholders
• supporting plans and initiatives to meet customer and business needs
• identifying and communicating goals and objectives
• building accountability for and measuring progress in achieving results
• identifying and addressing improvement opportunities
• demonstrating adaptability and promoting continuous learning.

Provides supervision and development opportunities for associates by

hiring and training

• mentoring
• assigning duties
• providing recognition
• ensuring diversity awareness.

Ensures compliance with company policies and procedures and supports company mission, values, and standards of ethics and integrity by

• implementing related action plans
• utilizing and supporting the Open Door Policy
• providing direction and guidance on applying these in executing business processes and practices.

#LI-MF4

Live our Values 

Culture Champion 

• Models the Walmart values to foster our culture; holds oneself and others accountable; and supports Walmart’s commitment to communities, social justice, corporate social responsibility, and sustainability; maintains and promotes the highest standards of integrity, ethics and compliance. 

Servant Leadership 

• Acts as an altruistic servant leader and is consistently humble, self-aware, honest, and transparent. 

Embrace Change 

Curiosity & Courage 

• Demonstrates curiosity and a growth mindset; fosters an environment that supports learning, innovation, and intelligent risk-taking; and exhibits resilience in the face of setbacks. 

Digital Transformation & Change 

• Seeks and implements continuous improvements and encourages the team to leverage new digital tools and ways of working. 

Deliver for the Customer 

Customer Focus 

• Delivers expected business results while putting the customer first and consistently applying an omni-merchant mindset and the EDLP and EDLC business models to all plans. 

Strategic Thinking 

• Adopts a holistic perspective that considers data, analytics, customer insights, and different parts of the business when making plans and shaping the team’s strategy. 

Focus on our Associates 

Diversity, Equity & Inclusion 

• Identifies, attracts, and retains diverse and inclusive team members; builds a high-performing team; embraces diversity in all its forms; and actively supports diversity goal programs. 

Collaboration & Influence 

• Builds strong and trusting relationships with team members and business partners; works collaboratively and cross-functionally to achieve objectives; and communicates with energy and positivity to motivate, influence, and inspire commitment and action. 

Talent Management 

• Creates a discipline and focus around developing talent, promotes an environment allowing everyone to bring their best selves to work, empowers associates and partners to act in the best interest of the customer and company, and regularly recognizes others’ contributions and accomplishments. 

Minimum Qualifications...

Outlined below are the required minimum qualifications for this position. If none are listed, there are no minimum qualifications.

Preferred Qualifications...

Outlined below are the optional preferred qualifications for this position. If none are listed, there are no preferred qualifications.

Primary Location...