Director, Revenue Cycle Management

Description

POSITION OVERVIEW

The Director, Revenue Cycle Management (RCM) is responsible for the strategic oversight, development, and execution of all functions within the revenue cycle, from patient access through final account resolution. This leadership role ensures the financial health of the organization by optimizing reimbursement, maintaining regulatory compliance, improving operational efficiency, and supporting long-term organizational goals. The Director serves as a key liaison between executive leadership, clinical operations, payers, and RCM staff, providing expert guidance across billing, coding, collections, denial management, and financial reporting functions.

ESSENTIAL FUNCTIONS INCLUDE, BUT ARE NOT LIMITED TO

• Develop and implement strategic plans and performance benchmarks for all RCM departments, including billing, coding, A/R management, payment posting, and collections.
• Lead and mentor RCM managers and department heads to ensure alignment with organizational objectives.
• Oversee RCM operations to ensure compliance with payer requirements, government regulations (Medicare/Medicaid), HIPAA, and internal policies.
• Analyze and report key revenue cycle metrics (e.g., cash collections, days in A/R, denial rates) and develop improvement initiatives accordingly.
• Serve as a liaison to executive leadership, delivering regular updates on financial performance, risk areas, and process improvement strategies.
• Collaborate with IT, clinical, and administrative teams to ensure EHR and billing systems are effectively integrated and optimized.
• Monitor industry changes in reimbursement trends, compliance regulations, and payer contracting; adjust strategies accordingly.
• Lead the selection, training, and performance evaluations of RCM staff; foster a culture of accountability, collaboration, and continuous improvement.
• Oversee payer contract management and credentialing processes to ensure proper enrollment and timely reimbursement.
• Identify and implement automation, outsourcing, or technology solutions that streamline workflows and enhance cash flow.
• Performs other duties as assigned.

Requirements

MINIMUM REQUIREMENTS / QUALIFICATIONS

• Bachelor’s degree in healthcare administration, business, finance, or related field required; master’s degree (MBA, MHA, or similar) preferred.
• Minimum of 7–10 years of progressive experience in revenue cycle management, including at least 3 years in a senior leadership role.
• Expertise in revenue cycle platforms, EHR/PM systems, analytics tools and payer portals.
• In-depth knowledge of medical billing, payer contracting, denial management, healthcare compliance, and revenue cycle best practices.
• Proficient Microsoft Office skills, especially Excel and PowerPoint.

KEY CHARACTERISTICS

• Team Player: Ability to work co-operatively and collaboratively with all levels of employees, management, and external customers to maximize performance and problem solving
• Integrity & Accountability: Unwavering commitment to doing what is right and upholding ethical standards. Takes ownership of tasks and maintains thorough documentation.
• Visionary Leader: Demonstrates strategic thinking and long-term planning capabilities to align RCM goals with organizational growth.
• Data-Driven: Uses analytics to assess performance, identify trends, and guide data-informed decision-making.
• Change Agent: Proactively identifies opportunities for process improvement and leads change initiatives with confidence.
• Highly Organized: Able to manage multiple projects and priorities in a fast-paced environment.
• Process-Oriented: Implements consistent workflows to improve claim accuracy, reduce denials, and speed up collections.
• Detail-Oriented: Maintains precision in documentation, auditing, and policy development.
• Exceptional Communicator: Excellent communication skills, both verbal and written. Capable of translating complex financial and operational data into clear recommendations for executives and stakeholders.

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

• Specific vision requirements include the ability to see at close range, distance vision, peripheral vision, depth perception