Manager, RCM Operations Effectiveness

JOB DESCRIPTION

Job Title: Manager, RCM Operations Effectiveness

Position Type: Full Time

Work Setting: In Office

Group/Division/Team: RCM, Operations

Reports to: Sr. Manager, RCM Operations

FLSA: Salary, Exempt

THE POSITION

The Manager, RCM Operations Effectiveness, identifies and leads initiatives that maximize cash flow, accelerate collections, and reduce bad debt through the strengthening of frontline collections performance and redesigning workflows. This role provides strategic and operational oversight of accounts receivable, collections, reimbursement, and payer follow-up activities while partnering closely with frontline leaders and staff to improve processes, remove barriers, and drive accountability. The Manager develops and executes strategies and projects that improve recovery of outstanding balances, reduce write-offs, optimize reimbursement, and support sustainable financial performance through continuous improvement and team development.

ESSENTIAL RESPONSIBILITIES

• Provide strategic leadership and project oversight for collections, recovery, and bad debt management initiatives to maximize cash flow and minimize write-offs across the organization.
• Develop, implement, and continuously refine department-wide strategies and projects to accelerate collections, reduce aged receivables, and improve overall recovery performance.
• Analyze bad debt trends and recovery outcomes to identify root causes and drive process improvements that enhance frontline team effectiveness and prevent future revenue leakage.
• Lead, coach, and develop frontline leaders and operational teams, fostering a culture of accountability, continuous improvement, and operational excellence.
• Monitor and drive performance against collection, recovery, and bad debt reduction metrics, ensuring timely action plans are developed and executed when targets are not met.
• Support the payment posting, account reconciliation, and collection reporting processes to ensure accuracy, transparency, compliance, and timely follow-up on outstanding balances.
• Partner cross-functionally with Revenue Cycle Management, Finance, Customer Care, Technology, and other stakeholders to identify opportunities for process improvement and operational efficiency.
• Document, standardize, and maintain collection and recovery workflows, policies, and procedures across RCM Operations teams to drive consistency, scalability, compliance, and knowledge transfer.
• Lead operational effectiveness initiatives, including process redesign, workflow optimization, automation opportunities, and performance improvement projects.
• Utilize data analytics, reporting, and performance insights to identify trends, measure effectiveness, and support informed decision-making across the revenue cycle.

REQUIRED EXPERIENCE & QUALIFICATIONS

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field; equivalent experience may be considered
• 8+ years of progressive experience in claims, medical billing, or insurance collections, with a strong track record of resolving aged or denied claims.
• 5+ years of leadership experience in Revenue Cycle Management.
• Strong knowledge of payer behavior, denial management, reimbursement processes, and revenue cycle best practices.
• Proven ability to develop and implement operational strategies and projects that improve financial performance, reduce aged receivables, and increase recovery rates.
• Strong analytical and problem-solving skills with the ability to interpret performance data, identify trends, and effectively implement corrective actions.
• Excellent communication, collaboration, and stakeholder management skills.
• Strong problem-solving, change management, and process improvement capabilities.
• Demonstrated ability to manage multiple priorities and initiatives in a fast-paced, evolving environment.
• High attention to detail and proficiency with Excel, SQL, and revenue cycle management platforms.
• Experience in quality assurance, process auditing, or operational controls is a plus.

Key Metrics

• Bad Debt Rate
• Bad Debt Dollars Recovered
• RCM Operations Paid Rate
• Denial Rates
• Team QA Scores
• Mail Room SLAs

COMPENTENCIES: Core to all positions at VaxCare

We Live (and Work) by Our Values:

- Building a team culture founded on trust, collaboration, and delivery excellence

- Belief in Something Bigger than Ourselves - Capacity to derive meaning from a larger purpose

- Humility as a Posture of Learning - Burning curiosity to learn without ego

- Adaptability & Embracing Change - Nimbleness & ready to seize new opportunities

Additional "Must Haves":

- Dependability - Must be able to meet deadlines, work independently, maintain focus, & punctual

- Interpersonal Skills - Builds strong relationships & contributes to a positive work environment.

- Computer Skills - Skilled with computers, learns new tools quickly.

- Ethics - Honest, accountable, maintains confidentiality.

OTHER RESPONSIBILITIES

• Commute to Office: Must be able to commute to and from the corporate office for each scheduled shift.
• Prolonged sitting or standing: Team members must be able to remain in a stationary position for extended periods, as much of the work involves sitting at a computer or workstation. Some hybrid or office-based roles may also require the ability to stand for portions of a shift.
• Repetitive motions: Significant use of the hands, wrists, and fingers is required for tasks like typing, using a computer mouse, and handling paperwork.
• Treating data engineering as a craft, with strong attention to correctness, performance, and maintainability
• Visual acuity: This job requires the ability to view a computer screen and read documents for extended periods.
• Communication: Team members must be able to clearly express and exchange ideas in English to effectively communicate with customers and co-workers.
• Occasional lifting: Many office-based jobs specify the ability to occasionally lift or move up to 10-20 pounds to handle supplies or equipment.

Physical Requirements/Work Environment:

TASK

Continuous

Intermittent

Seldom

N/A

Regular & Reliable Attendance

X

Standing/Walking

X

Travel/Driving/Operating Vehicle

X

Sitting (desk/computer work)

X

Lifting/Lowering/Carrying (up to 20lbs)

X

Reaching/Bending/Twisting

X

Hand/Wrist Use (typing/mouse/writing)

X

In person attendance for meetings/conferences

X

Operating Mobile Equipment/Machinery

X

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My signature further acknowledges that I have reviewed this job description and understand that I have the individual responsibility to fulfill all the essential duties and responsibilities listed on a consistent and ongoing basis.

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Note: Team Members in this position will be responsible for implementing and acting in accordance with VaxCare's information security policies; protecting assets from unauthorized access, disclosure, modification, destruction or interference; executing specific security processes or activities as assigned by the Information Security and/ or Privacy officers; and reporting security events or potential security risks to the organization. Team Members in this role will be involved in the processing of protected patient and/or payment information and will be responsible for ensuring the security and privacy of the information within their scope of work.