Location: Hybrid in Houston, TX or New Orleans, LA preferred

Summary Description

The Director - Revenue Cycle Operations serves as the Revenue Cycle Management domain lead within the Strategic Delivery function and is responsible for ensuring successful operational design, implementation, stabilization, and transition of strategic client engagements. The role provides deep functional expertise across billing, charge entry, payment posting, accounts receivable, denials, appeals, collections, and related back-end revenue cycle functions. Primary accountability includes translating contractual commitments and client expectations into executable operating models, validating workload and staffing assumptions, supporting operational readiness, resolving delivery challenges, and helping strategic engagements achieve defined service, quality, productivity, and financial outcomes. This position works closely with Customer Success, Onshore and Offshore Operations, Product, Technology, Quality, Training, Compliance, and client stakeholders. Direct ownership of routine steady-state production is not the primary focus. Strategic Delivery involvement will typically extend from contract execution through implementation and the initial stabilization period, followed by structured transition to the designated Operations team with periodic delivery assurance reviews thereafter.
Job Responsibilities

• Strategic Delivery & Implementation L
  • Lead Revenue Cycle delivery planning for strategic client implementations and complex operational transitions
  • Translate contract scope, client expectations, workflows, volumes, and service requirements into executable operating plans
  • Conduct operational discovery and validate assumptions before implementation
  • Perform detailed inventory analysis across AR, billing, denials, payment posting, charge entry, and related workflows
  • Develop effort estimates, productivity assumptions, staffing requirements, skill profiles, and capacity models
  • Identify operational risks, dependencies, access requirements, and implementation gaps before go-live
  • Establish implementation milestones, readiness criteria, ownership, and escalation pathways
  • Partner with Patient Access and Coding Strategic Delivery leads to ensure end-to-end alignment across the revenue cycle
• Revenue Cycle Domain Leadership
  • Provide subject matter expertise across charge entry, claims submission and billing, payment posting, AR follow-up, denial management and appeals, collections, credit balances and refunds, payer follow-up, reimbursement workflows, and inventory management
  • Evaluate existing client workflows and recommend scalable, efficient operating models
  • Analyze payer behavior, aging trends, denial patterns, reimbursement issues, and revenue leakage opportunities
  • Support Operations teams with complex functional issues and critical client escalations
  • Recommend solutions based on operational data, root-cause analysis, and industry best practices
• Pre-Go-Live Readiness
  • Validate scope, volumes, productivity benchmarks, staffing assumptions, and client expectations prior to launch
  • Support workforce planning, hiring profiles, candidate assessment, and staffing readiness
  • Define operational service levels, key performance indicators, quality expectations, turnaround times, and productivity standards
  • Ensure process documentation and standard operating procedures are complete and aligned with contractual requirements
  • Support development and validation of training programs, knowledge assessments, and operational readiness plans
  • Confirm system access, payer portal access, reporting requirements, workflow queues, and client dependencies
  • Partner with Product and Technology teams to validate product configuration and workflow readiness
• Go-Live & Delivery Assurance
  • Provide hands-on delivery leadership during strategic client go-lives
  • Establish and lead daily governance during critical implementation periods
  • Monitor production volumes, inventory, backlog, quality, productivity, turnaround time, and staffing utilization
  • Support production planning and workload prioritization
  • Coordinate resolution of operational, product, system, workflow, access, and training issues
  • Provide functional guidance to Onshore and Offshore Operations teams
  • Participate in client implementation and delivery meetings as needed
  • Maintain structured risk, issue, dependency, and action tracking
  • Escalate material risks with clear recommendations, owners, and recovery plans
• Stabilization - First 90 Days
  • Lead delivery assurance through the initial stabilization period for assigned strategic engagements
  • Monitor performance against agreed SLAs, KPIs, productivity, quality, and financial expectations
  • Conduct root-cause analysis for recurring operational issues and implement corrective action plans
  • Review staffing against actual production demand and recommend adjustments where appropriate
  • Identify training gaps and facilitate targeted retraining or knowledge reinforcement
  • Ensure SOPs remain current as workflows evolve during implementation
  • Partner with Operations leadership to build independent delivery capability
  • Drive timely resolution of customer concerns and delivery escalations
  • Support account-level gross margin improvement by identifying operational inefficiencies and staffing opportunities
• Transition to Steady-State Operations
  • Develop and execute a structured transition plan to the designated Onshore or Offshore Operations team
  • Ensure complete knowledge transfer, documentation, training, reporting, and ownership before handoff
  • Establish clear steady-state roles and responsibilities across Operations, Customer Success, Product, and support functions
  • Define exit criteria and validate operational readiness before Strategic Delivery ownership is reduced
  • Continue periodic delivery assurance reviews for strategic accounts following transition
  • Re-engage when material delivery risk, escalation, or performance deterioration is identified
• Performance Management & Analytics
  • Establish performance scorecards for strategic implementations and stabilization programs
  • Monitor and analyze key RCM indicators including Days in AR, aging distribution, denial rates, clean claim rate, first-pass yield, collection efficiency, cash acceleration, productivity, quality, backlog, and turnaround time
  • Convert operational data into recommendations, corrective actions, and measurable improvement plans
  • Provide concise executive reporting on implementation status, risks, client impact, and required actions
• Client & Stakeholder Governance
  • Serve as a senior operational subject matter expert for strategic client engagements
  • Participate in implementation calls, operational reviews, MBRs, QBRs, and escalation discussions as required
  • Partner closely with Customer Success to ensure client commitments are reflected accurately in operational delivery
  • Maintain strong alignment between client expectations, contractual commitments, product capabilities, and operational execution
  • Present solution-oriented recommendations rather than only identifying delivery problems
  • Support customer confidence through strong domain expertise, structured communication, and timely resolution of issues
• Product, Technology & AI Enablement
  • Partner with Product teams, including RCM+, PA+, and other relevant platforms, to align technology capabilities with client workflows
  • Identify opportunities for automation, artificial intelligence, workflow optimization, and reduction of manual effort
  • Translate operational pain points into clearly defined product requirements and improvement opportunities
  • Support testing, workflow validation, and implementation of new technology capabilities
  • Capture recurring operational issues that may warrant product or process redesign
• SOP, Training & Knowledge Management
  • Ensure complete and current SOPs are developed for assigned strategic engagements
  • Build repeatable delivery playbooks and implementation standards
  • Facilitate knowledge transfer between client-facing, onshore, and offshore teams
  • Ensure critical knowledge is institutionalized rather than dependent on individual resources
  • Conduct post-implementation lessons-learned reviews
  • Translate lessons learned into improvements to SOPs, training materials, workflows, implementation frameworks, and product capabilities
• Global Delivery Collaboration
  • Partner with Offshore Operations leadership to establish scalable delivery models for strategic engagements
  • Support offshore readiness, skill development, staffing, training, and knowledge transfer
  • Ensure alignment between onshore and offshore teams on scope, workflows, performance expectations, and escalation protocols
  • Provide domain guidance during complex production or client situations
  • Facilitate transition of work to offshore teams where appropriate while protecting service quality and client expectations
  • Support development of standardized operating rhythms across geographies
• Continuous Improvement & Delivery Excellence
  • Identify recurring delivery gaps across strategic accounts and develop repeatable solutions
  • Promote standardization across client implementations while accommodating legitimate client-specific requirements
  • Develop reusable templates, checklists, dashboards, and delivery playbooks
  • Support development and continuous improvement of the Strategic Delivery operating framework
  • Identify opportunities to improve scalability, quality, productivity, customer satisfaction, and gross margin

Job Requirements:

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field
  • Master's degree in Healthcare Administration, Business Administration, or related field
• 10+ years of progressive experience in healthcare Revenue Cycle Management
• 5+ years in a leadership, consulting, implementation, transition, or operational transformation capacity preferred
• Deep hands-on knowledge of end-to-end physician and/or ambulatory RCM workflows
• Strong experience across billing, payment posting, AR, denials, appeals, collections, and reimbursement processes
• Demonstrated experience leading complex client implementations, operational transitions, or performance improvement initiatives
• Proven ability to analyze inventory, volumes, productivity, staffing requirements, and operational capacity
• Experience developing SOPs, training frameworks, operational controls, and performance metrics
• Demonstrated success resolving complex delivery issues and client escalations
• Experience working with global or offshore delivery teams strongly preferred
• Experience partnering with Product and Technology teams on workflow automation or digital transformation initiatives preferred
• Strong understanding of payer processes, reimbursement methodologies, denial management, and revenue cycle performance indicators
• Relevant certifications preferred, such as:
  • Certified Revenue Cycle Representative or equivalent
  • Lean Six Sigma or process improvement certification
  • Project management or transition management certification
• Deep Revenue Cycle Management domain expertise
• Strong critical thinking and structured problem-solving capability
• Strong operational and financial analytical skills
• Ability to translate client requirements into scalable operating solutions
• Strong implementation and transition management capability
• Executive-level communication and presentation skills
• Strong customer-facing and stakeholder-management capability
• Ability to influence cross-functional teams without direct reporting authority
• Strong understanding of operational performance metrics and analytics
• Strong documentation, SOP, and knowledge-transfer capabilities
• Ability to operate effectively across Onshore and Offshore teams
• Strong change-management and escalation-management capability
• Ability to work effectively in ambiguous, high-growth, and rapidly changing environments
• Solution-oriented mindset with strong focus on customer outcomes
• Experience with major RCM platforms, practice management systems, electronic health record systems, payer portals, workflow tools, and reporting platforms
• Working knowledge of automation and AI applications within Revenue Cycle Management preferred
• Ability to travel approximately 20-30% for strategic client implementations, operational workshops, training, and escalation support

Success Measures

• Strategic implementation readiness and go-live success
• Time to operational stabilization