Director of RCM

Understood Care, Inc.; Los Angeles (CA); Hybrid; USD 120,000 - 190,000; Full time

Benefits offered by this job

Equity

Health insurance

Dental insurance

Paid time off

Job summary

Understood Care, Inc. is seeking a hands-on RCM leader to own the revenue cycle from start to finish. You will lead a 5-person remote billing team, drive collections, and oversee claims processing, contracting, credentialing, and denial triage.

You will partner with operations and engineering to prevent denials upstream and to automate billing workflows, while maintaining CMS compliance and reporting revenue performance to leadership.

Qualifications

• 5+ years in healthcare RCM with leadership experience
• Deep experience billing Medicare and Medicare Advantage
• Hands-on payer contracting and credentialing
• Track record of improving collections and reducing denials
• Strong analytical skills with data, dashboards, reporting
• Interest in partnering with engineers to automate processes

Responsibilities

• Lead a 5-person remote RCM team and set productivity/quality standards
• Own collection goals and core RCM KPIs (clean claim rate, denial rate, days in A/R, net collection rate)
• Oversee Medicare/Medicare Advantage claims processing from start to finish
• Manage payer contracting and provider credentialing
• Run denials triage and root-cause analysis to resolve issues quickly
• Collaborate with operations and engineering to automate workflows and prevent denials

Skills

RCM leadership

Medicare/Medicare Advantage

Payer contracting

Credentialing

Denials reduction

Analytics & dashboards

Process automation

Job description

Understood Care is a Medicare-enrolled patient advocacy and care navigation company. We pair patients with dedicated advocates who help them navigate the healthcare system, and we bill Medicare and Medicare Advantage for Principal Illness Navigation (PIN) and Community Health Integration (CHI) services. We're a small, fast-moving team, and our engineers work directly alongside operations to automate workflows.

The Role

We're looking for a hands-on RCM leader to own our revenue cycle from start to finish. You'll lead our 5-person remote billing team, take responsibility for our collection goals, and oversee claims processing, contracting and credentialing, and rejections triage. You'll also work closely with our operations and engineering teams to prevent denials at the source and turn manual billing work into automated workflows.

What You'll Do

• Lead, coach, and hold accountable a 5-person RCM team, and set clear productivity and quality standards
• Own collection goals and core RCM KPIs: clean claim rate, denial rate, days in A/R, and net collection rate
• Oversee claims processing for Medicare and Medicare Advantage from start to finish: charge capture, submission, payment posting, denials, and appeals
• Manage payer contracting and provider credentialing
• Run rejections and denials triage, find root causes, and resolve issues quickly
• Work with ops and engineering to prevent as many denials as possible upstream, and to design and prioritize billing automation and reporting
• Keep billing compliant with CMS guidelines and payer-specific requirements
• Report on revenue performance to leadership regularly

What We're Looking For

• 5+ years in healthcare RCM, including 2+ years leading a billing or collections team
• Deep experience billing Medicare and Medicare Advantage plans
• Hands-on experience with payer contracting and credentialing
• A track record of improving collections and reducing denials
• Strong analytical skills and comfort working with data, dashboards, and reporting
• Interest in working closely with engineers to improve processes through technology

Nice to Have

• Based in Southern California, or willing to relocate, and able to transition to a hybrid schedule in Irvine
• Experience with care management or time-based codes (PIN, CHI, CCM, PCM, or similar)
• Background at a care navigation, value-based care, or digital health company
• Experience scaling an RCM function at a startup
• Generous equity package
• Health and dental insurance
• Paid time off

Understood Care is an equal opportunity employer. We welcome candidates of all backgrounds.