Full-Time Director, Revenue Cycle Management

Director of Revenue Cycle Management will report to the Senior Vice President, Partner Success.

Responsibilities:

• Ensuring operational excellence in revenue cycle operations (coding & billing).
• Maintaining a coding philosophy supporting care quality & clinical outcomes.
• Creating & executing repeatable & scalable coding/billing playbooks.
• Partnering with technical teams to maintain/refine coding & billing platform configuration.
• Establishing KPIs & developing dashboards/reports for performance/compliance monitoring.
• Ensuring all care team billing practices comply with regulations (HIPAA, state-specific Medicaid).
• Partnering with compliance & audit personnel to ensure billing/coding policies conform to compliance/quality requirements.
• Partnering with external consultants/vendors to assess/implement state-specific Medicaid coding/billing procedures.
• Collaborating with payers to understand requirements & resolve issues.
• Providing leadership to a growing revenue cycle management team.
• Partnering cross-functionally with Compliance, Quality & Safety, Clinical Delivery, & operational teams.
• Partnering with Growth & Partner Success teams to evaluate relevant regulations for new states.

Qualifications:

• 8+ years managing revenue cycle operations in a high-growth environment (CMS/commercial payers).
• 4+ years managing/mentoring team members.
• Experience in value-based care &/or Medicaid preferred.
• Experience in a high-growth, nationally expanding provider organization.
• Ability to craft/improve coding/billing processes.
• Experience owning relationships with EHR/RCM vendors preferred.
• Certified medical coding background.
• Prior tele-health experience preferred.

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