Head of Revenue Cycle Management

Prosper Health is on a mission to make life happier and healthier for the 8 million autistic adults in the US. Autism prevalence is up >5x in the last 25 years, but autistic adults have been ignored by the traditional support and service system. This has contributed to alarmingly poor outcomes across mental and physical health, and vocational and social measures for autistic adults. Prosper Health is changing this by building a holistic suite of supports for autistic and neurodivergent adults.

Currently, we deliver best-in-class, specialized mental health services for autistic adults, covered by insurance. The response to our offering has been strong - in 18 months we have reached multiple millions of annualized revenue, >1,000 active clients, and ~100 clinicians.

 

The Role

As the first person to hold this title and reporting directly to our CEO, you have a unique opportunity to define the metrics, take process from 0 to 1, and build our Revenue Cycle function from the ground up. We have significant traction, and you will play a pivotal role in creating much of the foundation of our billing policies, RCM best practices, and KPI management as we continue to scale. Your work will span across all dimensions of RCM. You will:

• Collaborate closely with our CEO, founding team, clients, and clinicians to define Prosper’s revenue cycle strategy
• Define relevant KPIs and metrics as they relate to RCM, set targets for these metrics, and identify levers to achieve our targets
• Oversee end-to-end RCM related functions including eligibility, billing, collections, and reporting / analysis
  • Elgibility: Utilize claims data to manage our eligibility software vendor to improve accuracy of eligibility and benefit estimates for clients; decrease % of clients that are OON and make it to an appointment; track and optimize prior authorization process for revelant clients
  • Billing: Oversee in-house resources and third party vendor to ensure accurate coding and submission of claims; improve claim submission process to increase automation, first pass rates, and collections
  • Collections: Manage 3rd party billing vendor and ensure they are meeting SLAs and targets; monitor and analyze collections data to identify opportunities for improvements and when relevant, implement strategy and process changes to drive improvements
• As one of Prosper’s first 10 employees, help shape the future of the company and build our early culture!

About You

• 5-7+ years of experience in consulting, investment banking, early-stage startup, healthcare or related field
  • 2+ years in an RCM-related role
  • Experience in mental health digital health not required, but a plus!
• Knowledge of key RCM functions, including eligibility, claims submission, and collections
• Excited by the early stage (you will be one of the first 10 employees), which means working in a fast-paced environment with a high degree of ambiguity and an opportunity to take ownership
• Strategic, first-principled thinker who can independently identify key priorities and develop action plans to execute against them
• Analytical and data-oriented, with a strong ability to use numbers to make decisions
• Gritty, scrappy, and resilient, with a strong bias for action
• Motivated to do good and be great

How to Apply

Fill out the application below and email ben@prosperhealth.io and anna@prosperhealth.io with the following information:

• Your resume
• A link to your LinkedIn, personal website, or online profile
• Brief answers to the following questions:
  • Why you are excited about Prosper Health?
  • What you are most proud of in life (can be personal, social, professional)?

 

More about Prosper Health

Our team: We are building a world class team of creative, thoughtful problem-solvers, and pairing them with subject-matter experts from our field (e.g., clinicians, autistic self-advocates). Our operations team is concentrated in New York and consists of members from places such as Bain, Charlie Health, SeatGeek, Harvard, Northwestern, Dartmouth, Vanderbilt, Yale, and more.

Our culture:

• Clients first - when making decisions, we optimize for our clients; we stay extremely close to our community so we know their needs better than anyone
• Honesty and transparency - startups run into trouble when they delude themselves from reality; we are honest with ourselves and with each other in pursuit of our mission
• Desire to win - our work is hard, and we want people that are excited by conquering great challenges
• Enjoy the journey - have fun with each other and enjoy the day to day moments
• Growth mindset - we will not get everything right the first time, but we seek feedback, we iterate, and we improve
• Prefer to work in-person in NYC (but open to virtual for the right candidate)