Remote Revenue Cycle Strategy & Operations Manager

Pomelo Care; Northern (KY); Remote; USD 135,000 - 150,000; Full time

Benefits offered by this job

Fully remote work flexibility (within‑

Equity grant participation

401(k) program

Health, Dental, Vision coverage

HSA options

FSA

16 weeks paid parental leave

Job summary

Pomelo Care is seeking a Senior Revenue Cycle Strategy and Operations Manager to lead strategic RCM initiatives across multiple lines of business. You will design pricing, build scalable billing models, and address high-level escalations while partnering with Finance, Sales, Product, and Tech.

You will optimize processes, drive data-driven decisions, monitor policy updates, and implement robust governance to maximize patient care revenue and organizational efficiency.

Qualifications

• 5-7 years in healthcare revenue cycle.
• Experience designing pricing structures and collaborating with product/tech.
• Proficient in Excel/Google Sheets; basic SQL.
• Experience with BI tools (Metabase/Tableau/Looker) and data-driven decisions.

Responsibilities

• Partner with Finance and Sales to design pricing strategies and build hybrid FFS/PEMPM billing models.
• Serve as the dedicated resolution point for high-level RCM escalations.
• Collaborate with internal tech teams to build, scale, and maintain RCM software; ensure data integrity across systems.
• Monitor regulatory updates and payer rule changes to assess financial impact and adapt systems.
• Use BI and financial modeling to analyze KPIs, audit workflows, reconcile payments, and identify denials.
• Develop QA frameworks, SOPs, and audit guidelines to raise operational rigor.
• Oversee day-to-day revenue cycle execution including claims submission and payment posting.

Skills

Revenue cycle

Start-up experience

SQL basics

Excel/Google Sheets

BI tooling

Data analysis

Cross-team collaboration

Pricing strategy

Project management

Strategic thinking

AI tooling

Tools

Metabase

Tableau

Looker

Job description

Pomelo Care is seeking a Senior Revenue Cycle Strategy and Operations Manager to lead strategic RCM initiatives across multiple lines of business. You will design pricing, build scalable billing models, and address high-level escalations while partnering with Finance, Sales, Product, and Tech.

You will optimize processes, drive data-driven decisions, monitor policy updates, and implement robust governance to maximize patient care revenue and organizational efficiency.