Director, RCMS US Operations

Job Description:

Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts’ comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients.  Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions.

If you want to work inside an atmosphere where innovation has purpose, and your ambition works to support our customers and those they serve, please apply today!

Summary of the Director, RCMS

The Director, RCMS oversees day-to-day needs for RCMS Relationship Management with a focus specialized in developing high-level advocacy for clients and serving as primary point of contact throughout delivery of a professional services engagement. Strategically, this role is focused and responsible for client satisfaction and growth of business relationships, generally with profit and loss responsibility. The Director ensures on-time
delivery and meeting contract obligations. Additionally, the Director oversees billing configuration support for RCMS customers, ensuring timely setup of billing requirements and fee schedule updates, validation of successful billing support with the clearinghouse, and ongoing maintenance of revenue cycle settings within the EHR.

Responsibilities for the Director, RCMS

• Manage and oversee day to day needs for a Team of relationship managers and configuration analysts
• Serve as the liaison for cross department coordination and collaboration
• Serve as an advisor on complex customer issues
• Ensure client satisfaction, business relationship growth, and foster new engagements
• Devise solutions based on limited information and precedent, and adapts existing approaches to resolve issues
• Consult with Team members and agencies on complex RCM requirements
• Ensure the revenue cycle is processing appropriately and KPIs are within expected parameters
• Proactively analyze the client financial health regularly to identify reimbursement trends, patterns of denials, and to develop an intimate understanding of the factors that are contributing to the clients’ financial performance
• Manage onboarding, churn and configuration of RCMS customers
• Oversee customer RCMS contracts
• Consult with management and RCM team to develop a mitigation plan for RCM risks (functional gaps and inefficiencies) associated with the revenue cycle
• Resolve concerns with customer(s) and team member(s)
• Research and share billing information pertinent to states and insurances.
• Lead efforts in payer and industry research impacting customers' businesses
• Coordinate with team members to ensure metrics are met for contracts assigned
• Monitor accounts for KPI performance and escalations
• Provide oversight for month-end processing, including invoicing validation
• Possess wide-ranging experience, using in-depth professional knowledge, acumen, concepts and company objectives to develop, resolve complex customer clinical and business requirements

Qualifications of the Director, RCMS

• Bachelor’s degree, plus 10 years of related experience in client success; or master’s degree plus 4 years of experience in Revenue Cycle Management
• Experience in EHR applications for medical billing, or Behavioral Healthcare billing preferred
• Customer Relationship Experience (CRM) – Communication Skills (written/oral) and Active Listening Skills 
• Project Management Skills (PM) – Action Planning/Change Management and Organizational Skills 
• Financial/Revenue Cycle/Business Background – Financial Literacy and Negotiation Training 
• Healthcare Background – Behavioral Health Experience and Cultural/Community Awareness 
• Growth/Sales/Sales Support Experience – Creating Value Approach and Solution minded  
• Excellent customer service skills
• Excellent written and oral communication skills

Knowledge, Skills, and Abilities of the Director, RCMS

• Competent in executing