Billing Manager, Social Care Network

Company Overview:

Public Health Solutions (PHS) is a 501(c)3 non-profit community-based organization (CBO) that has existed for 70 years to improve health equity and address health-related social needs (HRSN) for historically underserved marginalized communities. As the largest public health nonprofit serving New York City, we improve health outcomes and help communities thrive by providing services directly to vulnerable families, supporting community-based organizations through our long-standing public-private partnerships, and bridging the gap between healthcare and community services. We focus on a wide range of public health issues including food and nutrition, health insurance, maternal and child health, sexual and reproductive health, tobacco control, and HIV/AIDS. Learn more about our work at healthsolutions.org.

PHS administers WholeYouNYC (WYNYC), a coordinated community resource network that builds trustworthy and reliable pathways between healthcare providers, health plans and CBOs providing critical resources in the community that address the social drivers of health. WYNYC brings together over 100 organizations offering various programs - such as food, housing, employment, health insurance, and sexual health services - across all five boroughs. These services and programs make it possible for New Yorkers to live their healthiest lives and ultimately reduce health disparities and advance health equity. To date, our network has already impacted thousands of lives through community partnerships and referrals, generating millions in estimated healthcare savings.

New York State (NYS) recently announced the availability of $500M statewide to support Social Care Network (SCN) lead entities responsible for coordinating social care delivery in various regions across the state. Public Health Solutions (PHS) and our WYNYC network were awarded the role of regional SCN for Brooklyn, Manhattan, and Queens.

This is a grant-funded position ending March 31, 2027.

Position Summary:

Specifically, the Billing Manager will work in close collaboration with the Senior Director and Deputy Director of Program Delivery and Operations, Coordination Center Operations Manager and others across the organization to:

• Team Oversight & Workflow Management

• Supervise the billing team, providing leadership, coaching, and performance oversight.

• Ensure timely review and determination (approval or rejection) of all HRSN invoices submitted by providers.

• Monitor daily invoice queues to ensure no backlog of outstanding invoices.

• Quality Assurance & Compliance

• Conduct regular QA audits to confirm invoice submissions align with NYS HRSN billing guidelines and fee schedules.

• Ensure all services billed are appropriately documented and eligible for reimbursement.

• Identify discrepancies and ensure accurate invoice coding, documentation, and provider compliance.

• Invoice Resolution & Support

• Serve as a point of escalation for provider billing inquiries and support needs.

• Investigate and identify root causes of rejected invoices; collaborate with providers and internal teams to resolve issues.

• Provide education and technical assistance to providers to prevent recurring billing errors.

• Payment & Data Disbursement Coordination

• Work closely with the finance team to ensure timely disbursement of provider payments for approved invoices.

• Collaborate with the disbursement vendor to ensure invoice data is accurately captured, tracked, and reflected in the HRSN provider payment portals.

• Monitor reconciliation of payment data between billing systems and disbursement platforms to maintain financial integrity.

• Partner with the disbursement vendor to identify and resolve data discrepancies across multiple data systems and vendors.

• Cross-functional Coordination

• Liaise with the Coordination Center Operations team to verify service eligibility and ensure invoices are aligned with care coordination activities.

• Partner with finance and compliance teams to align billing processes with contractual and regulatory requirements.

• Ensure seamless communication and data exchange between billing, operations, network and provider support teams.

• Performance Monitoring & Reporting

• Track key metrics including:

• HRSN Services Paid Within 30 Days

• HRSN Services Submitted Within 90 Days

• Develop and implement strategies to meet or exceed these benchmarks.

• Generate regular billing reports and present performance updates to leadership.

• Perform other duties and functions as assigned.

Qualifications and Experience:

• Bachelor's degree in Health Administration, Business, Finance, or related field and/or equivalent ; advanced degree or medical billing certification is a plus.
• 3-5 years of experience in healthcare billing, claims management, or revenue cycle operations, preferably with NYS Medicaid or value-based care programs.
• 2+ years of supervisory or team leadership experience.
• Strong understanding of NYS billing regulations, especially related to HRSN and Medicaid billing
• Experience working with disbursement vendors, third-party billing systems, or financial reconciliation tools.
• High degree of independence, initiative, problem-solving, and time-management skills.
• Ability to flexibly adapt to new information and requests, potentially requiring a shift in priorities.
• Exceptional listening, writing, oral, and presentation skills.
• Excellent team player with substantial experience working in collaborative environments.
• High level of self-awareness and diplomacy; comfortable interacting with all levels of management.
• Strong ability to quickly learn tasks and new topics and apply critical thinking skills.
• Proficient in Microsoft Office 365 Suite applications.
• Based in New York City with the ability to travel across the five boroughs as needed.
• Dedicated to improving the lives of vulnerable and marginalized communities.

Desired Skills:

• Foundational knowledge of the healthcare and social service sectors to include a solid understanding of the network of health and human service providers in NYC / NYS and related government agencies.
• Prior understanding of Social Determinants of Health is a plus.

Benefits:

• Hybrid Work Schedule.
• Generous Paid Time Off and Holidays.
• An attractive and comprehensive benefits package including Medical, Dental and Vision.
• Flexible Spending Accounts and Commuter Benefits.
• Company Paid Life Insurance and Disability Coverage.
• 403(b) + employer matching and discretionary company contributions.
• College Savings Plan.
• Ongoing trainings and continuous opportunities for professional growth and development.

At PHS, we place immense value on diversity within our teams, understanding that varied backgrounds and experiences significantly enhance our community and propel us toward our goals. If you find you don't have experience in all the areas listed above, we still encourage you to apply and share your background and experiences in your application. We are eager to discover how your unique perspective can bring positive transformations to our team and help advance our mission of creating healthier, more equitable communities.

We look forward to learning more about you!

PHS is proud to be an equal opportunity employer and encourages applications from women, people of color, persons with disabilities, LGBTQIA+ individuals, and veterans.

Monday - Friday

9am -5pm

35 hours per week.