Revenue Cycle Management (RCM) Program Director

ClinDCast, LLC; Wesley Chapel (FL); Presencial; USD 180.000 - 240.000; Tempo integral

Resumo da vaga

ClinDCast, LLC is seeking a Revenue Cycle Management (RCM) Program Director to lead end-to-end operations across multiple facilities, focusing on optimizing net collections and reducing denial rates. The role requires Epic RCM proficiency, strategic leadership, and the ability to collaborate with clinical, financial, and IT teams while ensuring CMS and HIPAA compliance and audit readiness. Experience across Medicaid, Medicare, and commercial payer models is essential.

Qualificações

• 5+ years leading end-to-end revenue cycle operations.
• Deep knowledge of Medicaid, Medicare, and commercial reimbursement.
• Experience in managing enterprise RCM teams.
• KPI management: A/R days, denial rate, net collections.
• Regulatory & audit controls: CMS/HIPAA compliance.
• Epic RCM modules: Prelude, Cadence, Resolute HB/PB.
• Executive communication to senior leadership.
• Specialized facility domain knowledge in behavioral health or state facilities.

Responsabilidades

• Drive end-to-end revenue cycle strategy to optimize net collections and reduce denials.
• Lead Epic RCM optimization (Prelude, Cadence, Resolute HB/PB) and workflow governance.
• Manage Medicaid, Medicare, Medicaid Managed Care, and commercial billing with CMS/HIPAA compliance.
• Partner with senior leadership and payers to align clinical operations, finance, and IT with financial goals.

Conhecimentos

Full-Cycle RCM

Payer Expertise

Enterprise Leadership

KPI Management

Regulatory & Audit Control

Epic Proficiency

Executive Communication

Specialized Facility Domain Knowledge

Descrição da vaga

Revenue Cycle Management (RCM) Program Director

Job#: 2231 - Revenue Cycle Management (RCM) Program Director

Job Description:

Key Responsibilities

• Strategic Leadership: Drive end-to-end revenue cycle operations and strategy to optimize net collections, reduce denial rates, and improve A/R days across DSOHF facilities.
• System & Workflow Governance: Lead Epic revenue cycle system optimization (Prelude, Cadence, Resolute HB/PB), automation, analytics, and reporting.
• Compliance & Reimbursement: Manage complex Medicaid, Medicaid Managed Care, Medicare, and commercial billing; ensure strict adherence to CMS, HIPAA, and state regulations while maintaining audit readiness.
• Stakeholder & Operations Alignment: Partner with senior leadership, state agencies, and payer organizations to align clinical operations, finance, and IT with overall financial goals.

Required Skills & Qualifications (5+ Years Each)

• Full-Cycle RCM: Comprehensive experience across patient access, HIM/coding, billing, A/R, and denials.
• Payer Expertise: In-depth knowledge of Medicaid, Medicaid Managed Care, Medicare, and commercial reimbursement models.
• Enterprise Leadership: Proven track record managing enterprise revenue cycle teams and departmental managers.
• KPI Management: Expertise in driving key metrics (A/R days, clean claim rate, denial rate, net collections).
• Regulatory & Audit Control: Deep understanding of CMS, HIPAA, state policies, and internal compliance frameworks.
• Epic Proficiency: Hands-on experience with Epic RCM modules (Prelude, Cadence, Resolute HB/PB) and workflow management.
• Executive Communication: Demonstrated ability to report complex financial, operational, and regulatory insights to executive leadership.
• Specialized Facility Domain Knowledge: Direct background managing RCM operations for behavioral health, psychiatric care, developmental disabilities, or state-operated facilities.