Senior Director Revenue Cycle Management
JOB DESCRIPTIONJob Title: Senior Director Revenue Cycle Management
Position Type: Full Time
Work Setting: Hybrid
Group/Division/Team: Revenue Cycle Management
Reports to: VP Revenue Cycle Management
FLSA: Exempt
The PositionThe Senior Director of Revenue Cycle Management (RCM) will lead backend revenue cycle operations for a national vaccine administration organization operating across 44 states. This role is heavily focused on
denial management, accounts receivable optimization, and scalable workflow design in a
high-volume environment processing over 5 million claims annually.
The ideal candidate brings deep expertise in
denial management operations, clearinghouse workflows, and the broader RCM technology ecosystem, coupled with a strong track record of driving
process improvement and automation. This role will also require a working understanding of how billing platforms integrate with multiple partner EHR systems to support a distributed care delivery model.
KEY RESPONSIBILITIES Revenue Cycle Operations- Lead day-to-day operations across the full revenue cycle, including:
- Patient registration and eligibility
- Charge capture and coding
- Claims submission and clearinghouse management
- Payment posting, AR follow-up, and denial management
- Manage throughput and performance in a high-volume claims environment with a focus on accuracy, timeliness, and scalability
- Establish and monitor KPIs (e.g., clean claim rate, days in AR, denial rate, net collection rate)
Technology & Systems Optimization- Serve as a strategic leader in RCM technology and systems, including EHRs, practice management systems, and clearinghouses
- Partner with IT and vendors to:
- Design and optimize charge routing, payer logic, and claim edits
- Implement automation, AI, and workflow tools to improve efficiency
- Lead system upgrades, integrations, and process redesign initiatives
Denials & Payer Strategy- Drive enterprise denial management strategy:
- Root cause analysis and remediation
- Payer-specific workflow optimization
- Partner with payer contracting and compliance teams to ensure alignment with:
- Vaccine billing requirements (including CMS, state Medicaid variations, and commercial payer policies)
- Timely filing and documentation standards
Compliance & Regulatory Oversight- Ensure adherence to federal and state billing regulations across 44 states
- Maintain audit-ready processes for CMS, Medicaid, and commercial payer requirements
- Oversee compliance related to vaccine administration billing, including counseling, preventive services, and modifier usage
Leadership & Team Development- Lead and develop high-performing RCM teams (onshore/offshore as applicable)
- Establish accountability through clear performance expectations and regular reporting cadence
- Drive continuous improvement culture focused on scalability and quality
Cross-Functional Collaboration- Partner with clinical operations, finance, IT, and external vendors to align revenue cycle strategy with organizational growth
- Support executive leadership with reporting, forecasting, and decision support related to revenue performance
Experience & QualificationsEducation- Bachelor's degree in healthcare, business, health information management, or a related field
- Master's degree preferred
Experience- 7+ years of progressive experience in Revenue Cycle Management, including leadership roles
- Demonstrated success managing operations in a high-volume environment
- Deep understanding of:
- Medicare, Medicaid, and commercial payer billing
- Denial management and AR optimization
- End-to-end RCM workflows
- Strong experience with RCM technology platforms, including:
- EHR systems
- Clearinghouses ()
- Revenue cycle analytics and reporting tools
- Proven ability to lead operational transformation and implement scalable process improvements
Preferred Qualifications- Experience in vaccine administration, outpatient services, or high-throughput preventive care models
- RCM Consulting experience with exposure to multi-client or multi-state environments
- Experience managing multi-state regulatory complexity
Other Responsibilities- Commute to Office (if applicable): 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 the majority of work involves sitting or standing at a computer or workstation.
- Repetitive motions: Significant use of the hands, wrists, and fingers is required for tasks like typing, using a computer mouse, and handling paperwork.
- 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.
