Director of Front-End RCM - NYC

Carex Consulting Group; New York (NY); Vor Ort; USD 180.000 - 240.000; Vollzeit

Zusammenfassung

Carex Consulting Group is seeking an experienced Director of Front-End Revenue Cycle Management to lead and grow our front-end RCM functions for behavioral health services. The role focuses on verification of benefits, prior authorizations, and utilization review, driving performance and operational excellence in a fast-paced environment.

You will build processes, scale teams, and collaborate with Product and Engineering to leverage automation and AI to improve workflows, while ensuring

Qualifikationen

• 7+ years of experience in revenue cycle management, patient access, utilization management, or related healthcare operations.
• Direct experience leading VOB, Prior Authorization, and/or Utilization Review teams within behavioral health or RCM services.

Aufgaben

• Lead and scale front-end RCM operations: Oversee VOB, prior authorizations, and utilization review, building structure to support growth.
• Drive day-to-day performance across front-end RCM workflows with accuracy and efficiency.
• Build and develop a high-performing team: coach, hire, onboard, and train as the function expands.
• Identify bottlenecks, implement standardized processes, and improve efficiency and quality.
• Develop and track KPIs related to verification accuracy, Authorization turnaround times, productivity, and denial prevention.
• Serve as escalation point for insurance verification, authorization, and medical necessity issues.
• Collaborate with Product and Engineering to improve tooling and identify automation opportunities.
• Partner with leadership to scale front-end RCM capabilities as the organization grows.

Kenntnisse

Revenue cycle management

Team leadership

Healthcare operations

Data analysis

Automation mindset

Tools

Automation tools

Jobbeschreibung

Carex is partnering with a rapidly growing, well-funded healthtech startup that is transforming how behavioral health organizations manage their clinical, operational, and revenue cycle workflows. With an AI-powered platform designed to streamline traditionally fragmented processes, this organization is scaling quickly and looking for an experienced Director of Front-End Revenue Cycle Management (RCM) to lead and grow its front-end RCM function. This leader will oversee an existing team responsible for verification of benefits (VOB), prior authorizations, and utilization review (UR), while building the processes, structure, and operational excellence needed to support continued growth. The ideal candidate has direct experience managing these functions within a behavioral health facility or RCM services organization, ideally supporting inpatient or residential treatment settings.

This is a hands‑on leadership opportunity for someone who thrives in a fast-paced startup environment and enjoys building and scaling operations. You'll have the opportunity to drive meaningful improvements in front‑end RCM performance, leverage technology and automation to streamline workflows, and play a critical role in shaping how the organization delivers revenue cycle services to its growing customer base.

What You'll Do

• Lead and scale front‑end RCM operations: Oversee an existing team responsible for verification of benefits, prior authorizations, and utilization review, while building the structure and processes needed to support growth.
• Drive operational excellence: Own day‑to‑day performance across front‑end RCM workflows, ensuring accuracy, efficiency, and timely completion of insurance verification and authorization activities.
• Build and develop a high‑performing team: Coach existing team members, identify staffing needs, and lead hiring, onboarding, and training efforts as the function expands.
• Optimize processes and workflows: Identify operational bottlenecks, implement standardized processes, and continuously improve the efficiency and quality of front‑end revenue cycle operations.
• Establish and own key performance metrics: Develop and track KPIs related to verification accuracy, authorization turnaround times, productivity, and denial prevention.
• Navigate complex payer requirements: Serve as an escalation point for challenging insurance verification, authorization, medical necessity, and utilization review issues.
• Leverage technology and automation: Collaborate with Product and Engineering teams to improve internal tooling, identify automation opportunities, and help shape technology solutions that support front‑end RCM workflows.
• Support strategic growth: Partner with leadership to scale front‑end RCM capabilities as the organization expands its customer base, ensuring operational performance keeps pace with growth.

What You'll Bring

• 7+ years of experience in revenue cycle management, patient access, utilization management, or related healthcare operations, including experience managing teams.
• Direct experience leading VOB, Prior Authorization, and/or Utilization Review teams within a behavioral health facility or RCM services organization.
• Strong understanding of behavioral health reimbursement, insurance verification, payer requirements, authorization workflows, and medical necessity criteria.
• Experience supporting inpatient or residential behavioral health treatment settings strongly preferred.
• Proven track record of building, improving, or scaling revenue cycle operations, including developing processes, managing performance, and growing teams.
• Experience navigating complex payer environments, including commercial insurance, Medicaid, and Medicare.
• Strong analytical skills and a data‑driven approach to identifying inefficiencies and improving operational performance.
• Technology‑forward mindset with an interest in leveraging automation and AI to improve traditionally manual RCM processes.
• Comfortable working in a fast‑paced, evolving startup environment where priorities shift and processes are still being built.
• Ability to work onsite in New York City.

Carex Consulting Group is an equal opportunity employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, marital status, disability, gender identity or Veteran status.