Director, RCM Shared Services

Astera Cancer Care; Nashville (TN); Remote; USD 140,000 - 210,000; Full time

Job summary

OneOncology is seeking a Director, RCM Shared Services (Urology) to lead strategic and operational revenue cycle initiatives across practice-based teams and third-party vendors. You will drive efficiency, optimize coding, and manage pre-authorization workflows to maximize reimbursement while sustaining high patient and provider satisfaction.

The role requires deep RCM leadership in a Urology-focused environment, with governance over denials, RVU productivity, and payer policy adherence.

Qualifications

• Bachelor’s degree or equivalent experience required.
• Experience managing third-party revenue cycle vendors or outsourced RCM services.
• Coding certification and knowledge of CPT/ICD-10-CM.
• Urology experience and familiarity with payer policies.
• Proficient in Microsoft Excel and PowerPoint.

Responsibilities

• Lead strategic and operational initiatives for RCM teams and vendors.
• Oversee CPT/ICD-10-CM coding optimization and denial management for urology services.
• Monitor payer trends and ensure regulatory compliance for urology billing.
• Collaborate with leadership to improve charge capture, documentation, and reimbursement outcomes.
• Manage vendor performance using KPIs and SLAs; provide performance reviews.

Skills

RCM leadership

Vendor management

Communication skills

Detail oriented

Urology experience

Education

Bachelor's degree

Coding certification

Tools

Excel

PowerPoint

Job description

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.Job Description:Role SummaryThe Director, RCM Shared Services (Urology) is responsible for leading strategic and operational initiatives for practice-based revenue cycle management (RCM) teams, third-party RCM vendors, and internal OneOncology stakeholders supporting urology practices. This position drives revenue cycle projects, utilizes analytics to optimize performance, implements best-practice workflows, and leads corporate in-house RCM teams focused on maximizing financial outcomes while maintaining exceptional patient and provider experiences.ResponsibilitiesEnsure accurate coding, charge capture, and reimbursement for urology office visits, diagnostic testing, surgical procedures, surgeries and ancillary services.Manage relationships with third-party revenue cycle vendors and global service partners as well as leading a US-based team.Oversee revenue cycle processes related to cystoscopy, prostate biopsy, urodynamics, imaging, ultrasound, lithotripsy, vasectomy, catheter management, and other common urologic procedures and surgeries.Manage pre-authorization and medical necessity workflows for surgical and procedural services, including hospital and ambulatory surgery center cases.Monitor payer reimbursement trends and regulatory changes impacting urology services and develop strategies to mitigate financial risks.Partner with management, coding, compliance, and provider leadership to ensure appropriate application of CPT, HCPCS, ICD-10-CM, and modifier usage specific to urology services.Oversee denial prevention and appeals processes for specialty-specific procedures, surgical claims, medical necessity denials, and bundled service edits.Ensure optimization of ancillary revenue streams, including pathology, laboratory, imaging, dispensing pharmacy, and other practice-based services.Collaborate with management, providers and practice leaders to improve charge capture, documentation quality, and reimbursement outcomes.Analyze procedure utilization, reimbursement performance, RVU productivity, denial trends, and net collection metrics to identify opportunities for improvement and report out on these metrics.Support implementation and optimization of practice management systems, EMRs, coding edits, and automation tools to improve revenue cycle effectiveness.Serve as a subject matter expert regarding urology/surgery reimbursement regulations, payer policies, fee schedules, and revenue cycle best practices.Ensure compliance with Medicare, Medicaid, commercial payer, and governmental regulations related to urologic services and physician practice billing.Lead revenue cycle readiness and integration efforts for acquisitions, new providers, service line expansions, and newly implemented ancillary services and any assigned lines of business.Monitor vendor performance using established KPIs, SLAs, and operational metrics.Collaborate with RCM team to improve reimbursement, collections, denial management, and workflow efficiency.Serve as the primary contact for division RCM communications, issue resolution, and performance reviews actively collaborating with management on identified issues.Ensure vendor compliance with contractual requirements, organizational policies, and regulatory standards.Qualifications5+ years of relevant healthcare and RCM leadership experience.Bachelor’s degree or equivalent experience required.Experience managing third-party revenue cycle vendors or outsourced RCM services preferred.Contract management and vendor oversight experience preferred.Coding certification preferredStrong background in managed care payer marketUrology experience required.Strong verbal and written communication skills required.Must be detail oriented and organizedStrong Microsoft Office skills required, including Excel and PowerPoint.High integrity, including maintenance of confidential informationAbility to work a flexible schedule based on business need, including some evenings and weekends.#LI-REMOTE