The intent of this job description is to provide a summary of the major duties and responsibilities performed in this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.

The Senior Revenue Cycle Management (RCM) Manager is a senior-level leader responsible for the strategic oversight, standardization, and optimization of revenue cycle operations across the organization, including affiliate practices operating outside of Epic and Athena. This role drives enterprise-wide RCM performance by leading high-performing teams, directing operational and analytical programs, and partnering with executive, clinical, and financial stakeholders to maximize revenue integrity and collection efficiency. The Senior RCM Manager serves as the organization's primary authority on RCM analytics - building the infrastructure for data-driven decision-making, overseeing performance reporting, and translating complex revenue data into actionable improvement strategies.

Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Strategic Leadership & Operations

• Provide senior-level leadership and strategic direction across all RCM functions, including billing, coding, collections, and payer relations.
• Oversee end-to-end RCM workflows for the enterprise and affiliate practices, ensuring operational consistency and standards compliance.
• Establish, enforce, and continuously refine standardized processes for charge capture, billing, A/R follow-up, and denial management.
• Direct and manage external billing vendors, including contract oversight, performance evaluation, and strategic relationship management.
• Lead the onboarding of new affiliate practices and service lines into the enterprise RCM model.
• Drive cross-functional collaboration with clinical operations, finance, IT, and compliance to address systemic revenue challenges.
• Own RCM budgeting, staffing strategy, and resource planning in alignment with organizational growth targets.
• Serve as a senior escalation point for complex payer disputes, underpayments, and compliance matters.
• Champion a culture of accountability, continuous improvement, and professional growth within the RCM team.
• Stay abreast of evolving payer regulations, CMS guidelines, coding updates, and industry best practices.

Team Development & Management

• Directly supervise and develop RCM Managers, Supervisors, and senior billing staff across departments and locations.
• Set performance expectations, conduct evaluations, and implement professional development programs for RCM personnel.
• Recruit, onboard, and retain high-performing RCM talent in alignment with organizational needs.
• Foster a data-literate team culture by training staff on analytics tools and performance metrics.

Analytics, Reporting & Data Strategy

As the senior analytics leader for RCM, this role owns the full spectrum of data strategy - from KPI governance and dashboard infrastructure to root cause investigation and executive reporting.

• Monitor and Report on RCM Key Performance Indicators (KPIs)

• Define, govern, and maintain the enterprise RCM KPI framework, including denial rates, clean claim rates, days in A/R, net collection rate, charge lag, and first-pass resolution rates.
• Deliver executive-level performance scorecards, trend analyses, and variance reports to VP of RCM, CFO, and organizational leadership.
• Establish performance benchmarks using industry standards (MGMA, HFMA) and internal historical data to drive goal-setting and accountability.
• Monitor real-time and periodic performance data across all affiliate and enterprise practices to surface emerging risks or opportunities.

• Build and Maintain Analytics Dashboards and Reporting Infrastructure

• Lead the design, development, and governance of enterprise-wide RCM analytics dashboards using Power BI, Tableau, or equivalent platforms.
• Partner with IT, data engineering, and BI teams to build and maintain reliable data pipelines, data dictionaries, and reporting infrastructure.
• Standardize reporting templates, data definitions, and metric calculations across all practices and business units.
• Develop and maintain a self-service analytics environment that empowers RCM managers and clinical operations teams with timely, accurate data.
• Produce ad hoc analytical reports and strategic briefings in response to leadership, payer, or regulatory requests.

• Conduct Root Cause Analysis on Revenue Issues

• Lead structured root cause analysis (RCA) investigations for denial spikes, A/R aging deterioration, underpayment trends, and collection shortfalls.
• Present RCA findings and corrective action plans to senior leadership with clear prioritization and accountability assignments.
• Monitor the effectiveness of corrective actions through longitudinal data review and close-loop reporting.
• Facilitate cross-functional task forces with billing vendors, coding, compliance, and payer representatives to resolve systemic issues identified through analysis.
• Maintain an issue tracking registry that documents recurring RCM challenges, root causes, interventions, and outcomes.

• Drive Data-Informed Strategic Improvement

• Translate analytics insights into prioritized, evidence-based improvement initiatives across the enterprise revenue cycle.
• Support multi-year strategic planning and annual budgeting with data-driven forecasting, scenario modeling, and ROI analysis.
• Identify automation and technology opportunities (AI-assisted coding, predictive denial management, etc.) based on data pattern analysis.
• Document analytical methodologies, findings, and improvement outcomes to support organizational knowledge management and audit readiness.

Required education and experience: The requirements listed below are representative of the knowledge, skills, and/or ability required.

Minimum Education required:

• High school diploma or equivalent.
• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field required. Master's degree (MHA, MBA, or equivalent) strongly preferred.
• Relevant professional certifications preferred (e.g., CRCR, CHFP, RHIA, or equivalent).

Minimum Experience Required:

• 8-10 years of progressive experience in healthcare revenue cycle management, with a minimum of 4 years in a senior leadership capacity managing managers or multi-site operations.
• Demonstrated experience owning enterprise-level RCM analytics programs, including dashboard development, KPI governance, and executive reporting.
• Deep experience with multi-specialty or multi-location medical group settings, including affiliate or joint-venture practice structures.
• Proficiency in Epic, Athena, eClinicalWorks, and major clearinghouse platforms required.

Minimum Knowledge and Skills Required:

• Comprehensive mastery of end-to-end RCM processes, including coding, billing, collections, denial management, and payer contracting.
• Proven ability to lead and develop high-performing, geographically distributed RCM teams.
• Executive-level communication skills with the ability to present complex financial and operational data to C-suite and board audiences.
• Advanced proficiency in RCM analytics and data visualization platforms (Power BI, Tableau, or equivalent); strong Excel skills required.
• Ability to design and govern enterprise analytics frameworks, KPI libraries, and self-service reporting environments.
• Strong analytical acumen with demonstrated ability to conduct root cause analysis, interpret trends, and translate data into strategic action.
• Expertise in identifying operational inefficiencies and designing scalable, technology-enabled solutions across complex multi-site environments.
• Familiarity with emerging RCM technologies including AI-assisted coding, predictive analytics, and automation platforms.