Project Manager

Insight Global; Mandaluyong; On-site; PHP 1,800,000 - 3,000,000; Full time

Job summary

Insight Global Health seeks an experienced Project Manager to lead offshore revenue cycle management services from Manila for onshore U.S. healthcare customers.

This role oversees RCM delivery teams and is accountable for planning, launching, and running projects that meet contracted service levels for quality, accuracy, turnaround time, productivity, and financial outcomes. Ideal candidates bring deep U.S.

Qualifications

• Bachelor’s degree in health information management, healthcare administration, business, finance, nursing, or related field.
• Master’s degree (MHA, MBA, or equivalent) preferred.
• Progressive RCM operations background in offshore delivery environments.

Responsibilities

• Lead RCM delivery teams to deliver high‑quality, accurate, and timely results.
• Plan and manage end‑to‑end RCM projects across front-end, mid-cycle, and back-end workflows.
• Define project scope, requirements, and success criteria with stakeholders.
• Manage budgets, RAID logs, and change control for multiple concurrent clients.

Skills

Project management

Leadership

English proficiency

Education

Bachelor's degree in health information management or related field

Master's degree preferred (MHA, MBA)

Tools

EHR systems (Epic, Cerner)

PM certifications (PMP)

Job description

Project Manager — Offshore Revenue Cycle Management

Offshore Revenue Cycle Services | Insight Global Health

Job Title

Project Manager — Offshore Revenue Cycle Management

Direct Reports

RCM team leads and delivery supervisors assigned to the project

Experience

12+ years in U.S. healthcare revenue cycle management and RCM project delivery

Employment

Full-Time

Travel

10–20% (periodic travel within Philippines/India; U.S. client and leadership visits as needed)

Job Summary

Insight Global Health is seeking an experienced Project Manager to lead the delivery of offshore revenue cycle management (RCM) services from Manila to onshore U.S. healthcare customers. This role leads RCM delivery teams — and is accountable for planning, launching, and running revenue cycle projects that meet contracted service levels for quality, accuracy, turnaround time, productivity, and financial outcomes.

The ideal candidate brings a deep background in U.S. healthcare revenue cycle operations combined with disciplined project management, strong leadership, and the ability to collaborate with internal teams and client stakeholders. The Project Manager works closely with U.S. program management and client account teams to translate each customer’s requirements into consistent, compliant, and scalable offshore delivery.

Key Responsibilities

RCM Project & Delivery Leadership

• Lead and mentor RCM delivery teams — team leads, coders, billers, AR and denial specialists, and authorization specialists — to deliver high-quality, accurate, and timely results
• Plan and manage end-to-end RCM projects across front-end (eligibility, registration, prior authorization), mid-cycle (coding, CDI, charge capture), and back-end (billing, AR follow-up, denials, payment posting) workflows
• Collaborate with internal and client stakeholders to define project scope, requirements, workflows, payer rules, timelines, and success criteria
• Ensure projects stay current with changes in ICD-10-CM/PCS, CPT/HCPCS, and MS-DRG guidelines, CMS and commercial payer policies, and prior authorization requirements
• Coordinate dependencies, shared resources, and cross-training across revenue cycle functions, from documentation and authorization through coding, billing, and collections
• Manage project plans, milestones, RAID (risks, assumptions, issues, dependencies) logs, change control, and budgets
• Apply structured project management methods (waterfall, Agile, or hybrid) to operational transitions and process improvement — not software development
• Manage operating budgets, labor utilization, and cost-per-transaction targets in partnership with Finance
• Escalate delivery, compliance, and client risks to leadership in a timely manner with clear mitigation plans

SLA Performance & Reporting

• Own SLA and KPI performance for assigned projects and clients, including quality, accuracy, turnaround time, productivity, and backlog
• Build performance dashboards covering coding accuracy, clean-claim rate, first-pass yield, denial rate and trends, AR days, prior authorization turnaround, and CDI query metrics
• Monitor daily, weekly, and monthly results; lead root-cause analysis, corrective action plans, and service-recovery efforts when results fall short
• Prepare and present results, improvement initiatives, and risk mitigation plans in monthly and quarterly client business reviews
• Drive continuous improvement through Lean, Six Sigma, workflow redesign, and automation to improve quality and productivity while controlling cost-to-serve

Client Transition & Program Stand-Up

• Lead new client transitions and program launches, including process mapping, knowledge transfer, hiring and onboarding plans, system access, and go-live readiness
• Define transition milestones and stabilization plans so new programs reach contracted SLA targets within agreed ramp timelines
• Develop standard operating procedures, desk-level work instructions, and client-specific playbooks
• Partner with Workforce Management, HR, and Facilities on capacity planning, shift design, and staffing models that support U.S. time zones

Compliance, Data Security & Risk

• Ensure project operations comply with HIPAA Privacy and Security Rules, client business associate agreements, India’s Digital Personal Data Protection Act, 2023, and client-specific security requirements
• Maintain audit-ready controls for PHI handling, system access, clean-desk and device policies, and incident reporting; support client and SOC 2 / ISO 27001 audits
• Oversee internal quality audits and compliance monitoring for coding, billing, denials, and authorization work
• Support business continuity and disaster recovery plans that protect SLA performance during outages and other disruptions
• Serve as the RCM business owner for technology and automation initiatives — define business requirements, workflows, and acceptance criteria rather than building solutions
• Partner with IT, automation, and vendor teams on EHR, clearinghouse, payer portal, RPA, and AI-assisted coding or authorization tools; lead user acceptance testing from an operations perspective
• Conduct quality calibration, coaching, and performance evaluations for RCM team leads and staff, tied to SLA and quality outcomes
• Work closely with HR and senior leadership to attract, develop, and retain top RCM talent, and build succession plans for team leads and emerging leaders
• Foster a culture of operational excellence, continuous improvement, collaboration, cross-cultural respect, and ownership of client outcomes

Required Qualifications

• Bachelor’s degree in health information management, healthcare administration, business, finance, nursing, or a related field; master’s degree (MHA, MBA, or equivalent) preferred. An engineering or computer science background is not required and does not substitute for revenue cycle experience
• 12+ years of U.S. healthcare revenue cycle management experience, including at least 5 years leading RCM projects, programs, client transitions, or operations teams
• Hands‑on RCM operations background in two or more of the following: patient access and eligibility, prior authorization, medical coding, CDI, charge capture, billing, AR follow‑up, denial management, or payment posting
• Progressive experience in a BPO, KPO, or offshore shared‑services environment delivering services to U.S. healthcare clients
• Proven track record of owning SLA and KPI performance against contracted targets for multiple concurrent clients, including client‑facing reviews and corrective action plans
• Strong working knowledge of the U.S. revenue cycle, including ICD‑10‑CM/PCS, CPT/HCPCS, MS‑DRG, payer reimbursement and authorization rules, and CMS regulations
• Working knowledge of HIPAA Privacy and Security Rules and experience operating in environments subject to client security audits
• Demonstrated project management discipline — plans, RAID logs, budgets, and change control — applied to operational delivery
• Experience with workforce management, capacity planning, and productivity and quality measurement for teams of 50+ FTEs
• Excellent communication, problem‑solving, and leadership skills, with advanced English proficiency for engagement with U.S. client stakeholders
• Ability to prioritize, strategize, and align RCM delivery with client and business objectives

Preferred Qualifications

• Project management certification such as PMP, PgMP, or PRINCE2; Lean Six Sigma Green or Black Belt
• Revenue cycle credentials such as CRCR, CPC, CCS, CPB, CCDS, or CDIP
• Experience standing up a new offshore program, service line, or delivery center, including client transition, knowledge transfer, hiring ramp, and go-live
• Hands‑on familiarity with EHR and revenue cycle platforms (Epic, Oracle Health/Cerner, Meditech, athenahealth), clearinghouses, encoder and CDI tools, UM criteria (InterQual, MCG), and payer portals
• Experience as the business owner for RCM automation, RPA, or AI‑assisted coding and authorization tools
• Budget ownership or input into client pricing and cost‑to‑serve models