The Director of Revenue Cycle Management provides strategic and operational leadership for the full revenue cycle at a Federally Qualified Health Center (FQHC) with significant value-based reimbursement activity.
This position oversees accurate charging, timely billing, cash collections, denial management, and revenue integrity across all service lines. The role also partners closely with Finance, Clinical Operations, Contracting, and Quality teams to support value-based care objectives, regulatory compliance, and organizational financial goals.
The Director reports directly to the Chief Financial Officer and supervises the Billing Manager as well as the Business Office and revenue cycle teams.
Duties and responsibilities
- Lead strategy and operations for charge capture, billing, accounts receivable, cash posting, denial management, and revenue integrity
- Develop revenue cycle strategies supporting value-based contracts, alternative payment models, and FQHC reimbursement methodologies
- Provide regular reporting to the CFO on performance, risks, trends, and opportunities
- Partner with Finance and Contracting on revenue recognition and contract performance
- Collaborate with Quality and Clinical Leadership on quality metrics, risk adjustment, and performance measures
- Oversee charge capture and claims submission across Medicaid, Medicare, managed care, and commercial payers
- Manage accounts receivable aging, follow-up workflows, and complex balance resolution
- Build and oversee denial management, including root-cause analysis and recovery efforts
- Monitor cash collections, payment posting accuracy, and reconciliation processes
- Lead revenue integrity initiatives to ensure compliant charging, coding alignment, and documentation support
- Manage the Business Office and revenue cycle teams, including coaching, performance management, and staff development
- Evaluate staffing models, workflows, and technology for scalability and efficiency
- Oversee payer contracts and provider enrollment
- Analyze procedures and implement process improvements
- Use billing software, EMR/EHR systems, and RCM tools
Qualifications
- Bachelor’s degree in Healthcare Administration, Finance, Business, or a related field
- Minimum 7 years of progressive healthcare revenue cycle management experience
- Experience supporting FQHC operations and reimbursement, including Medicaid and Medicare
- Strong understanding of value-based payment models, alternative payment arrangements, and revenue recognition
- Proven leadership experience managing business office and revenue cycle teams
- Knowledge of applicable federal, state, and local laws
- Ability to manage budgets, understand payer contracts, and interpret financial reports
- Strong leadership, communication, problem-solving, and project management skills
Location
Pennsylvania, US
Employment Type
Full-time
Experience Level
Director
Remote work allowed
No
Posted
5 months ago