Revenue Cycle Strategy & Operations Architect (Hybrid Billing)

Pomelo Care; United States; Remote; USD 135,000 - 150,000; Full time

Benefits offered by this job

Health coverage

Dental & Vision coverage

HSA options

FSA

Equity grant participation

401(k) program

Paid parental leave (16 weeks)

Fully remote within US

Job summary

Pomelo Care is a leading virtual medical practice serving women and children nationwide. We seek a Senior Revenue Cycle Strategy and Operations Manager to drive financial stewardship, data insights, and operational excellence across multiple billing models.

You will partner with Finance and Sales to design pricing, lead RCM initiatives for new B2B clients, and optimize our RCM software across EHRs and BI platforms. This role enables growth in a fast-paced startup, with remote work within the US.

Qualifications

• 5–7 years of healthcare revenue cycle experience or healthcare startup experience.
• Proven ability to partner with Finance to design pricing structures and collaborate with Product/Tech to build scalable tools.
• Deep understanding of commercial and Medicaid billing, claim formats, and denial resolution.

Responsibilities

• Partner with Finance and Sales to design pricing strategies and hybrid FFS/PEMPM billing models.
• Lead RCM onboarding for new B2B clients and resolve high-level escalations.
• Collaborate with internal tech teams to build and scale proprietary RCM software across EHRs and BI platforms.
• Monitor regulatory updates and payer rules to evaluate financial impact and preempt system changes.
• Use BI and financial modeling to analyze KPIs, audit billing workflows, and surface denial patterns.
• Develop QA frameworks, SOPs, and audit guidelines to elevate operational rigor.
• Oversee day-to-day revenue cycle execution including claims submission and payment posting.

Skills

Financial modeling

Excel

SQL

BI tools

Data analytics

Tools

Metabase

Tableau

Looker

Job description

Pomelo Care is a leading virtual medical practice serving women and children nationwide. We seek a Senior Revenue Cycle Strategy and Operations Manager to drive financial stewardship, data insights, and operational excellence across multiple billing models.

You will partner with Finance and Sales to design pricing, lead RCM initiatives for new B2B clients, and optimize our RCM software across EHRs and BI platforms. This role enables growth in a fast-paced startup, with remote work within the US.