Revenue Cycle Management (RCM) Program Director

TechWish

$125K — $150K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Minimum 5 years' experience in healthcare revenue cycle operations including patient access, coding, billing, and accounts receivable.
  • Strong understanding of Medicaid, Medicare, and commercial payer reimbursement processes.
  • Proven leadership in managing enterprise revenue cycle teams and specialized staff.
  • Expertise in managing key performance indicators like denial rates and clean claims.
  • Deep knowledge of CMS, HIPAA, and state regulations pertinent to revenue cycle management.
  • Proficient in Epic revenue cycle systems and workflow governance.
  • Exceptional communication skills for conveying complex information to stakeholders.

Responsibilities

  • Lead strategic direction for revenue cycle operations across all facilities.
  • Optimize financial performance and ensure compliance with regulatory requirements.
  • Minimize denials and improve cash flow through strategic initiatives.
  • Manage complex Medicaid and Medicare billing requirements effectively.
  • Oversee key performance metrics and reporting to guide operational enhancements.
  • Collaborate with senior leadership and payer organizations to align operations with financial goals.
  • Drive technology optimization within Epic and related systems for efficiency improvements.

Benefits

  • Opportunity to lead a multi-tiered team in a significant healthcare organization.
  • Engagement with senior leadership and state agencies for strategic initiatives.
  • Focus on improving operations in a dynamic and critical revenue cycle environment.
  • Chance to influence financial performance and compliance at a systemic level.
  • Resources for continuous professional development and technology enhancements.
Full Job Description
DHHS is seeking a Revenue Cycle Management (RCM) Program Director to provide leadership and strategic direction for all end-to-end revenue cycle operations across DSOHF 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.

Required/Desired Skills
Skill Required /Desired Amount of Experience 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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