Epic PB/HB PM

Duration: 1.5 yearsRemote / On-site requirement / Travel %: 50/50Project Details / Open ReasonMerging multiple Epic HB (Hospital Billing) and PB (Professional Billing) systems across a multi-entity health system where each entity currently bills separately. This resource will provide strategic planning, technical expertise, and operational alignment to ensure a seamless transition. Here’s an overview of key considerations and steps: Governance & Strategic PlanningEstablish an executive steering committee with representation from IT, revenue cycle, finance, compliance, and operations.Define the business goals of the consolidation (e.g., cost savings, standardization, improved patient experience).Align regulatory and compliance requirements (e.g., state laws, payer contracts, tax ID considerations). System Architecture & Data MigrationAssess the current Epic instances (versions, configurations, customizations).Determine the best approach:Single instance migration (combining into one environment).Hub-and-spoke model (maintaining separate instances but integrating key workflows). Develop a data migration strategy to consolidate patient accounts, claim history, and financial data while maintaining integrity. 3. Standardization of Billing & Revenue Cycle ProcessesAlign charge capture workflows across hospitals to standardize billing logic.Create a uniform chart of accounts and financial reporting structure.Standardize payer contracts and reimbursement structures where feasible.Define new billing and collections workflows to minimize disruptions in cash flow. Technology & Epic ConfigurationConfigure Epic Resolute HB/PB to support a consolidated billing model.Ensure crosswalk mapping for charge codes, service locations, and providers.Implement batch processing and automation to handle higher transaction volumes efficiently.Evaluate the need for interface integrations (e.g., clearinghouses, third-party payment systems). Testing & TrainingConduct parallel testing with sample claims to identify discrepancies before go-live.Develop a comprehensive training program for billing teams and end-users.Provide change management support to ensure smooth adoption across the organization. Go-Live & Post-Implementation OptimizationImplement a phased rollout to mitigate risk.Monitor KPIs such as claim denials, revenue cycle performance, and patient billing satisfaction.Continuously optimize workflows based on real-world performance and user feedback.Key Challenges to AnticipateResistance to change from revenue cycle teams accustomed to independent workflows.Variability in payer contracts and reimbursement models across entities.Managing patient billing transparency and communication.Ensuring regulatory compliance with HIPAA, CMS, and state-specific billing requirements.Required SkillsSeasoned PM experienceEpic HB/PB merge experienceCommunication with leadership