Senior Manager- Denials Management Operations
Location: Rochester
Posted on: June 23, 2025
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Job Description:
Mayo Clinic is top-ranked in more specialties than any other
care provider according to U.S. News & World Report. As we work
together to put the needs of the patient first, we are also
dedicated to our employees, investing in competitive compensation
and comprehensive benefit plans – to take care of you and your
family, now and in the future. And with continuing education and
advancement opportunities at every turn, you can build a long,
successful career with Mayo Clinic. Benefits Highlights • Medical:
Multiple plan options. • Dental: Delta Dental or reimbursement
account for flexible coverage. • Vision: Affordable plan with
national network. • Pre-Tax Savings: HSA and FSAs for eligible
expenses. • Retirement: Competitive retirement package to secure
your future. Responsibilities The Senior Manager – Denials
Management Operations plays a critical leadership role in the
execution and performance of day-to-day denial management
activities across a large, enterprise health system. This position
oversees multiple specialized teams responsible for managing
incoming, priority, and resolution-stage denials, ensuring optimal
performance in alignment with organizational goals and compliance
requirements. The ideal candidate brings strong operational
leadership, the ability to manage multi-skilled teams, and a firm
grasp of key revenue cycle KPIs. The Senior Manager will also
collaborate closely with PRIZM teams to align on denial trends,
provide feedback loops, and contribute to data-informed performance
improvement. Additionally, this role will be a key point of contact
for teams working with external global vendors, ensuring quality,
efficiency, and accountability. Key Responsibilities: • Direct
daily operations of denials management teams including those
focused on new incoming denials, priority denials, and denial
resolution. • Manage a team of Senior Representatives and
Representatives across multiple functions and locations. • Ensure
departmental and enterprise KPIs are tracked, met, and continuously
improved (e.g., denial overturn rates, days to resolve, appeal
success rates). • Partner closely with the PRIZM team to monitor
denial trends, identify feedback loops, and guide data-driven
improvements. • Provide frontline feedback on denial patterns to
upstream departments, including clinical documentation, patient
access, and billing teams. • Collaborate with enterprise vendor
management teams and global service providers to align on
operational execution, productivity, and quality expectations. •
Develop team performance metrics, conduct regular reviews, and
implement performance improvement strategies where necessary. •
Ensure all activities are compliant with payor guidelines,
organizational standards, and applicable regulatory requirements. •
Act as a coach and mentor to staff, fostering growth and engagement
through ongoing development and feedback. • Maintain a strong
operational rhythm with cross-functional stakeholders, ensuring
escalation pathways are in place and effectively utilized. •
Support broader revenue cycle initiatives, participating in
committees, task forces, or workgroups as needed. Qualifications
Required: • Bachelor’s degree in Business, Healthcare, Finance, or
related field, and 10 years of relevant experience including 5
years of leadership experience OR 14 years of relevant experience
in lieu of a degree, including at least 5 years managing people and
operations. • Proven ability to manage high-volume operational
teams in a complex healthcare environment. • Deep understanding of
denial workflows, appeals, root cause analysis, and operational
KPIs. • Demonstrated success managing people, driving performance
improvement, and optimizing team structures. • Experience working
in or closely with revenue cycle systems, including denial
management platforms like PRIZM. • Excellent communication and
relationship-building skills across administrative, clinical, and
vendor teams. Preferred: • Experience managing multi-site or remote
teams, including global vendor operations. • Familiarity with EPIC,
and other denial and appeal tracking tools. • Prior work in a large
academic health system or matrixed health enterprise. • Involvement
in denial prevention workgroups, HFMA task forces, or
payer-provider collaboration initiatives. Key Competencies: •
Operational Execution & Prioritization • Team Leadership & Talent
Development • Metrics-Driven Accountability • Stakeholder
Coordination & Feedback Loop Creation • Vendor Oversight &
Partnership Management • Revenue Cycle Process Knowledge • Strong
Communication & Situational Awareness Additional Information: •
This position may require occasional travel based on operational
needs or vendor coordination. • Ability to operate in a fast-paced,
performance-driven environment with rapidly changing
priorities.
Keywords: , Brooklyn Park , Senior Manager- Denials Management Operations, Healthcare , Rochester, Minnesota