Healthcare RCM PM

InnoSoul, Inc.; Raleigh (NC); Hybrid; USD 120,000 - 190,000; Full time

Job summary

North Carolina Department of Health and Human Services (DHHS) in Raleigh seeks a Revenue Cycle Management (RCM) Program Director to lead end-to-end revenue cycle operations across DSOHF facilities. You will direct patient access, HIM/coding, billing, A/R, payer management, and collections while driving strategy to improve cash flow and regulatory compliance.

The role requires 5+ years of leadership in enterprise revenue cycle, deep CMS/HIPAA knowledge, and expertise with Epic systems.

Qualifications

• Knowledge of full healthcare revenue cycle operations (patient access, HIM/coding, billing, A/R, denials).
• Understanding of Medicaid, Medicaid Managed Care, Medicare, and commercial payer reimbursement.
• Experience leading enterprise revenue cycle teams with managers and specialized staff.
• Ability to develop and execute revenue cycle strategy aligned with financial and compliance objectives.
• Expertise managing KPIs such as A/R days, denial *, clean claims, and net collections.
• Strong knowledge of CMS, HIPAA, state regulations, and payer policies.
• Skill in maintaining internal controls, audit readiness, and compliance frameworks.
• Proficiency with Epic revenue cycle systems (Prelude, Cadence, Resolute HB/PB) and workflow governance.
• Ability to lead technology optimization, analytics, automation, and reporting.
• Strong partnership across finance, clinical ops, IT, compliance, and payer orgs.
• Executive communication ability to present complex financial data.
• Financial acumen to evaluate trends and forecast cash.
• Competence in leading organizational change and standardized processes.
• Understanding of revenue cycle considerations for behavioral health, psychiatric care, developmental disabilities, and state-operated facilities.

Responsibilities

• Provide leadership and strategic direction for end-to-end revenue cycle operations across DSOHF facilities.
• Drive strategy to optimize financial performance and ensure regulatory compliance.
• Minimize denials and improve cash flow while guiding a multi-tiered team of managers and staff.
• Partner with senior leadership, state agencies, and payer organizations to align operations with financial goals.
• Oversee metrics and reporting, manage Medicaid/Medicare billing requirements, and ensure audit readiness.
• Guide technology optimization within Epic and related systems to improve efficiency and accountability.

Skills

Revenue cycle knowledge

Medicaid/Medicare reimbursement

Leading enterprise RC teams

KPIs management

CMS/HIPAA knowledge

Epic RCM systems

Executive communication

Behavioral health revenue cycle

Job description

Job ID: NC-811563 (912590923)

Hybrid/Local Healthcare RCM PM (15+) with HIM/Coding, Billing, A/R, CMS, HIPAA, Epic, Prelude, Cadence Resolute HB/PB and Medicaid experience

Location: Raleigh, NC (NCDHNS-IT Budget Office)
Duration: 7 Months

Skills

• Knowledge of full healthcare revenue cycle operations (patient access, HIM/coding, billing, A/R, denials). Required 5 Years
• Understanding of Medicaid, Medicaid Managed Care, Medicare, and commercial payer reimbursement. Required 5 Years
• Experience leading enterprise revenue cycle teams Required 5 Years
• Expertise managing KPIs such as A/R days, denial *, clean claims, and net collections Required 5 Years
• Strong knowledge of CMS, HIPAA, state regulations, and payer policies. Required 5 Years
• Proficiency with Epic revenue cycle systems (Prelude, Cadence, Resolute HB/PB) and workflow governance. Required 5 Years
• Executive communication ability Required 5 Years
• Understanding of revenue cycle considerations for behavioral health, psychiatric care, developmental disabilities, and state-operated facilities. Required 5 Years

Description

DHHS is seeking a Revenue Cycle Management (RCM) Program Director to provide leadership and strategic direction for all end to end revenue cycle operations across DSOHF facilities.

DHHS is seeking a Revenue Cycle Management (RCM) Program Director to provide leadership and strategic direction for all end to end revenue cycle operations across DSOHF facilities, including patient access, health information management, coding, billing, accounts receivable, payer management, and collections. This role drives strategy to optimize financial performance, ensure regulatory compliance, minimize denials, and improve cash flow while guiding a multi tiered team of managers and staff. The Director partners with senior leadership, state agencies, and payer organizations to align operations with financial goals, oversees key metrics and reporting, manages complex Medicaid/Medicare billing requirements, ensures audit readiness, and guides technology optimization within Epic and related systems to continuously improve efficiency and accountability.

Skills Set

• Knowledge of full healthcare revenue cycle operations (patient access, HIM/coding, billing, A/R, denials).
• Understanding of Medicaid, Medicaid Managed Care, Medicare, and commercial payer reimbursement.
• Experience leading enterprise revenue cycle teams with managers and specialized staff.
• Ability to develop and execute revenue cycle strategy aligned with financial and compliance objectives.
• Expertise managing KPIs such as A/R days, denial *, clean claims, and net collections.
• Strong knowledge of CMS, HIPAA, state regulations, and payer policies.
• Skill in maintaining internal controls, audit readiness, and compliance frameworks.
• Proficiency with Epic revenue cycle systems (Prelude, Cadence, Resolute HB/PB) and workflow governance.
• Ability to lead technology optimization, analytics, automation, and reporting.
• Strong partnership and collaboration skills across finance, clinical operations, IT, compliance, and payer organizations.
• Executive communication ability to present complex financial, operational, and regulatory information.
• Financial acumen to evaluate trends, forecast cash, assess reimbursement risks, and drive improvements.
• Competence in leading organizational change, standardization, and continuous improvement initiatives.
• Understanding of revenue cycle considerations for behavioral health, psychiatric care, developmental disabilities, and state-operated facilities.

NC-811563-SM.docx

NC-RTR-811563.docx