Manager Of Revenue Cycle Jobs (NOW HIRING)

The Director of Revenue Cycle provides strategic, operational, and financial leadership for all revenue cycle management (RCM) functions across a large, multi-site FQHC. This position oversees end-to-end revenue cycle operations for an organization serving approximately 200,000 patient visits annually with a clinical network of approximately 300 clinicians. 

The Director is responsible for optimizing financial performance, cash flow, and regulatory compliance across a complex, multi-service clinical model that includesFamily Practice, Dental, Optometry, Behavioral Health Therapy, ASAM (Addiction/SUD Services), and OB/GYN services. 

This role requires a highly analytical, mission-driven leader with extensive experience navigating FQHC regulations (PPS billing, HRSA compliance, sliding fee programs) and high-volume billing across both medical and behavioral health specialties.

Key Responsibilities 

Strategic Leadership & Financial Performance 

• Develop, implement, and continuously improve a unified, organization-wide revenue cycle strategy aligned with financial sustainability and HRSA compliance objectives. 
• Serve as the principal advisor to the executive leadership team on RCM performance, regulatory updates, and emerging reimbursement models. 
• Monitor and manage key performance indicators (KPIs) including Days in A/R, Clean Claim Rate, Denial Rate, Net Collection Rate, and Cost to Collect. 
• Lead annual revenue cycle budgeting, forecasting, and goal-setting processes for all service lines. 
• Collaborate cross-functionally with Clinical, Operations, IT, Compliance, and Finance leadership to align clinical documentation with optimal charge capture. 

Revenue Cycle Operations & Service Line Management 

• Oversee all daily front-end and back-end revenue cycle operations, including patient registration, insurance verification, sliding fee scale (SFS) assessment, copay collection, coding, billing, claims submission, payment posting, and collections. 
• Standardize and manage billing, coding, and workflow requirements across a highly diverse set of clinical specialties: 
  • Family Practice:FQHC Prospective Payment System (PPS) reimbursement, sliding fee discounts, preventive care, and preventive-to-chronic care transition billing. 
  • Behavioral Health (Therapy & ASAM):Multi-level addiction treatment, counseling, psychiatric evaluation, intensive outpatient program (IOP) billing, and 1115 Waiver models. 
  • Dental:CDT coding, FQHC dental encounters, and pediatric/adult Medicaid dental guidelines. 
  • Optometry:Coordination of vision hardware plans versus medical eye care insurance benefits. 
  • OB/GYN:Global OB billing packages, maternal health programs, and state-specific perinatal programs. 
  • Implement best-practice workflows to minimize denials and maximize first-pass claim rates. 

Compliance, Audit & Regulatory Oversight 

• Ensure full compliance with HRSA Section 330 grant requirements, UDS reporting mandates, PPS guidelines, and sliding fee discount program policies. 
• Maintain compliance with Federal and State regulations, including HIPAA, CMS guidelines, Medicaid/Medicare billing rules, and behavioral health parity laws. 
• Partner with the Compliance Officer to design and execute regular internal coding and documentation audits, ensuring any identified vulnerabilities are quickly addressed. 
• Stay current on state-specific Medicaid Managed Care Organization (MCO) rules and changing reimbursement guidelines. 

Team Leadership & Staff Development 

• Recruit, train, mentor, and evaluate a high-performing, multi-functional revenue cycle team across multiple departments and clinic sites. 
• Establish clear performance standards, productivity metrics, and quality expectations for all billing, coding, and RCM support staff. 
• Foster a collaborative culture of accountability, continuous learning, and professional growth. 
• Provide continuous training and education to RCM staff and clinical providers on documentation, coding standards, and payer guidelines. 

Technology & Electronic Health Record (EHR) Optimization 

• Direct the operational optimization and integration of the Epic Electronic Health Records (EHR) and Practice Management (PM) systems. 
• Evaluate, select, and implement automated RCM tools, clearinghouses, predictive denial management systems, and online patient billing integrations to drive operational efficiency. 
• Collaborate with IT and clinic leadership to troubleshoot system issues affecting claim submission or charge capture. 

Payer Relations, Contracting & Credentialing 

• Maintain and cultivate strategic relationships with key payers, including Medicaid MCOs, Medicare, commercial insurers, and state/county funding agencies. 
• Oversee the centralized provider credentialing and enrollment process to ensure timely clinician participation and prevent administrative write-offs. 
• Support contract negotiations by providing comprehensive, data-driven analysis of payer reimbursement performance, denial trends, and contract compliance. 

Reporting, Analytics & Business Intelligence 

• Develop, maintain, and present comprehensive RCM dashboards and performance reports to executive leadership and the Board of Directors. 
• Utilize advanced data analytics to perform root-cause analyses on billing denials, underpayments, and lagging accounts receivable. 
• Ensure accurate financial data reporting to support internal audits, external cost reports, and HRSA/UDS submissions. 

Qualifications 

Education/Certifications:

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field required. Master's degree (MHA, MBA, or equivalent) is highly preferred. 
• Certifications (Preferred):Professional certification such as Certified Revenue Cycle Professional (CRCP), Certified Professional Biller (CPB), Certified Professional Coder (CPC), or Fellow of the Healthcare Financial Management Association (FHFMA/CHFP).  

Experience 

• Leadership Experience:Minimum of7-10 yearsof progressive revenue cycle experience, with at least5 yearsin a director-level or senior leadership role within a healthcare system. 
• Large-Scale Operations:Proven experience managing RCM in a high-volume setting. 
• FQHC/Ambulatory Care Expertise:Highly preferred. Candidates must demonstrate deep knowledge of the FQHC Prospective Payment System (PPS) reimbursement, Sliding Fee Discount Program rules, and HRSA guidelines. 
• Specialized Service Lines:Direct experience overseeing billing/coding for behavioral health (specifically including ASAM/SUD treatment) alongside traditional medical, dental, and optometry services. 

Knowledge, Skills & Abilities 

• Comprehensive mastery of electronic billing systems, clearinghouses, and practice management databases. 
• In-depth understanding of CPT, ICD-10-CM, CDT, and DSM-5 coding conventions. 
• Exceptional analytical, problem-solving, and financial forecasting skills. 
• Strong interpersonal and communication skills, with the ability to influence positive change across clinical, operational, and financial teams. 
• Absolute commitment to the mission of providing high-quality healthcare to underserved, vulnerable, and diverse patient populations.