Interview Type: ***Webcam Interview Only *** Very long term project; initial PO for 1 year, expect to go for 4+ years ***Hybrid***
Job Description
The client is seeking a Revenue Cycle Management (RCM) Program Director to provide leadership and strategic direction for all end‑to‑end revenue cycle operations across client facilities, including patient access, health information management, coding, billing, accounts receivable, payer management, and collections.
This role drives strategy to optimize financial performance, ensure regulatory compliance, minimize denials, and improve cash flow while guiding a multi‑tiered team of managers and staff. The Director partners with senior leadership, state agencies, and payer organizations to align operations with financial goals, oversees key metrics and reporting, manages complex Medicaid/Medicare billing requirements, ensures audit readiness, and guides technology optimization within Epic and related systems to continuously improve efficiency and accountability.
Skills Set
- Knowledge of full healthcare revenue cycle operations (patient access, HIM/coding, billing, A/R, denials).
- Understanding of Medicaid, Medicaid Managed Care, Medicare, and commercial payer reimbursement.
- Experience leading enterprise revenue cycle teams with managers and specialized staff.
- Ability to develop and execute revenue cycle strategy aligned with financial and compliance objectives.
- Expertise managing KPIs such as A/R days, denial rate, clean claims, and net collections.
- Strong knowledge of CMS, HIPAA, state regulations, and payer policies.
- Skill in maintaining internal controls, audit readiness, and compliance frameworks.
- Proficiency with Epic revenue cycle systems (Prelude, Cadence, Resolute HB/PB) and workflow governance.
- Ability to lead technology optimization, analytics, automation, and reporting.
- Strong partnership and collaboration skills across finance, clinical operations, IT, compliance, and payer organizations.
- Executive communication ability to present complex financial, operational, and regulatory information.
- Financial acumen to evaluate trends, forecast cash, assess reimbursement risks, and drive improvements.
- Competence in leading organizational change, standardization, and continuous improvement initiatives.
- Understanding of revenue cycle considerations for behavioral health, psychiatric care, developmental disabilities, and state-operated facilities.
Skills/Requirements
- Knowledge of full healthcare revenue cycle operations (patient access, HIM/coding, billing, A/R, denials). Required 5 Years
- Understanding of Medicaid, Medicaid Managed Care, Medicare, and commercial payer reimbursement. Required 5 Years
- Experience leading enterprise revenue cycle teams Required 5 Years
- Expertise managing KPIs such as A/R days, denial rate, clean claims, and net collections Required 5 Years
- Strong knowledge of CMS, HIPAA, state regulations, and payer policies. Required 5 Years
- Proficiency with Epic revenue cycle systems (Prelude, Cadence, Resolute HB/PB) and workflow governance. Required 5 Years
- Executive communication ability Required 5 Years
- Understanding of revenue cycle considerations for behavioral health, psychiatric care, developmental disabilities, and state-operated facilities. Required 5 Years
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