Head of Revenue Cycle Operations

Special; Austin (TX); On-site; USD 250,000 - 420,000; Full time

Job summary

Figure Health in Austin is seeking a hands-on healthcare operations leader to design and run its centralized intake-to-cash organization across acquisitions nationwide.

You will own workflows, people, controls, metrics, and technology—driving automation with engineers, and ensuring Medicare/Medicaid compliance while scaling the business. A rare blend of operational excellence and technical fluency will be rewarded with broad impact and leadership responsibility.

Qualifications

• 7+ years in healthcare operations or related field.
• Experience leading managers and frontline teams.
• Knowledge of Medicare/Medicaid and payer rules.

Responsibilities

• Build the function: design the central operating model and recruit/manage leaders across intake, authorization, coding, QA, scheduling, billing.
• Integrate acquisitions: migrate agencies into Figure's standard model.
• Run intake-to-cash: own end-to-end flow from referral to final collection.
• Create operating discipline: define SOPs, queues, SLAs, staffing, escalation, quality checks, cadences.
• Own the numbers: build KPI system by agency/workflow and drive corrective action.
• Automate aggressively: work with engineers to translate pain into automation and measure impact.
• Protect quality and compliance: ensure billing, coding, docs, and QA meet payer rules.
• Manage vendors: oversee EHR, clearinghouse, and billing partners while reducing complexity.
• Scale nationally: create a repeatable operating model for growth.

Skills

Healthcare operations

Revenue cycle management

Leadership of managers

Data fluency

Tools

EHR systems

Clearinghouse

Billing software

Job description

About Figure Health

Figure Health is building a national senior care platform powered by SpecialOS, an AI-native operating system for healthcare services. Figure Health is part of Special, founded by Nate Cavanaugh and Justin Fox after their work at DOGE and backed by a16z, Human Capital, Antonio Gracias, Brian Armstrong, and other leading technology investors.

The Role

We are hiring a hands-on healthcare systems builder to design, recruit, and run Figure Health's centralized intake-to-cash organization across our acquisitions nationwide. This is not a traditional billing-management role. You will own the workflows, people, controls, metrics, and technology spanning referral intake, insurance verification, authorizations, order management, coding and OASIS review, scheduling operations, QA, billing, cash posting, denials, accounts receivable, and related administrative functions.

You will inherit fragmented processes across acquired agencies and turn them into one high-performing operating system. You must be equally comfortable mapping a broken workflow, managing a large distributed team, reviewing payer-level performance, and working directly with engineers to automate repetitive work.

What You Will Own

• Build the function: design the central operating model; recruit and manage leaders and teams across intake, authorization, order tracking, coding, QA, scheduling support, billing, collections, and denials.

• Integrate acquisitions: assess each agency's people, processes, systems, backlog, payer rules, and control environment; create and execute the migration plan into Figure's standard model.

• Run intake-to-cash: own performance from referral receipt through eligibility, authorization, scheduling readiness, documentation completion, coding, clean claim submission, payment, denial resolution, and final collection.

• Create operating discipline: define SOPs, work queues, service levels, staffing models, escalation paths, quality checks, and daily/weekly management cadences.

• Own the numbers: build a single KPI system by agency, payer, branch, and workflow; diagnose misses quickly and hold teams accountable for corrective action.

• Automate aggressively: partner with Special's engineering and forward-deployed teams to translate operational pain into product requirements, deploy automation, and measure realized impact.

• Protect quality and compliance: ensure billing, coding, documentation, authorization, and QA processes are accurate, auditable, and compliant with Medicare, Medicaid, commercial payer, and state requirements.

• Manage vendors and systems: select, negotiate with, and oversee EHR, clearinghouse, coding, billing, eligibility, and other operating partners while reducing unnecessary complexity.

• Scale nationally: create a repeatable operating model that can support rapid acquisition volume without linear growth in overhead or deterioration in patient experience.

What Success Looks Like

• First 30 days: map every workflow, team, system, backlog, and KPI at each acquired agency; identify immediate cash, quality, and staffing interventions.

• First 90 days: establish common scorecards and daily management; stabilize high-risk workflows; finalize the central-operations org design and hiring plan; launch the first automation priorities.

• First 12 months: operate one scalable intake-to-cash model across acquisitions, with faster referral response, cleaner claims, lower denial rates, reduced A/R, stronger labor productivity, and auditable quality controls.

The Ideal Candidate

• 7+ years in healthcare operations, revenue cycle, shared services, implementation, or a closely related function, including meaningful leadership of managers and frontline teams.

• Experience in revenue cycle, patient access, claims, clinical operations, or another operationally complex healthcare workflow; home-health expertise is helpful but not required.

• Working knowledge of Medicare, Medicaid, managed care, authorizations, claims, denials, and accounts receivable; familiarity with PDGM, OASIS, or home-health coding is a plus.

• Demonstrated success standardizing operations across multiple locations, business units, acquisitions, or payer environments.

• Highly technical and data-fluent: able to define system requirements, understand integrations and data flows, interrogate dashboards, and partner credibly with engineers.

• Exceptionally process-oriented, detail-obsessed, and comfortable going several levels deeper than a typical executive.

• Insanely high energy, with the urgency, stamina, and personal ownership to thrive in an intense, Elon-style operating culture.

• A builder with low ego and extreme agency - willing to personally solve problems before delegating them and then create a system that makes the solution repeatable.

• Strong recruiter and people manager who can set a high bar, build trust, create accountability, and develop a durable leadership bench.

• Comfortable in an acquisition-driven, fast-changing environment with incomplete information and high expectations.

• Exceptional academic achievement from a highly selective university is preferred; equivalent evidence of unusual achievement and intellectual horsepower is equally compelling.

• Based in Austin or willing to relocate; regular travel to acquired agencies is required.