Senior Manager- Denials Management Operations

Location: Rochester
Posted on: June 23, 2025

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: , Bloomington , Senior Manager- Denials Management Operations, Healthcare , Rochester, Minnesota