Revenue Cycle Management Director

Job title: Revenue Cycle Management Director

About the Role

Lead and optimize all revenue cycle operations, including billing, coding, claims processing, collections, denials management, and reimbursement optimization. Partner with Clinical Operations, Quality, Compliance, Contracting, Provider Relations, IT, and Executive Leadership to ensure accurate reimbursement and financial sustainability. This role is based in Phoenix with a hybrid schedule and requires experience with Medicare Advantage, Medicaid, value-based care, and population health payment structures.

What You'll Do

• Provide strategic oversight for all revenue cycle functions, including patient eligibility verification, charge capture, coding review, claims management, payment posting, collections, denial management, and reimbursement optimization.
• Develop and execute revenue cycle strategies aligned with organizational financial goals and growth initiatives.
• Establish department objectives, performance standards, and KPIs; develop annual goals, budgets, staffing plans, and roadmaps.
• Collaborate with executive leadership to identify opportunities to enhance revenue integrity and maximize reimbursement.
• Oversee billing and claims submission activities to ensure timely, accurate, and compliant reimbursement; monitor claims lifecycle metrics (clean claim rate, first-pass resolution, days in accounts receivable, denial rate, collections).
• Ensure proper billing practices for Medicare, Medicaid, commercial payers, and value-based care contracts; lead initiatives to improve claim accuracy and reduce denials.
• Analyze reimbursement trends and implement corrective actions to improve cash flow and reduce leakage.
• Denials & Revenue Integrity: develop and oversee denial management programs; monitor trends; address documentation, coding, and workflow issues; establish corrective action plans and educate staff to improve revenue capture.
• Contract & Payer Management: Partner with Finance to manage payer contracts and payer relationships; coordinate with Contracting and IT as needed to optimize systems and data.

What We're Looking For

• 7+ years revenue cycle experience with at least 3 years in a leadership role.
• Expertise in billing, coding, claims processing, denials, payer relations, Medicare/Medicaid/Medicare Advantage, value-based care, analytics, and process improvement.
• Extensive experience in healthcare revenue cycle operations, Medicare Advantage, Medicaid, risk adjustment reimbursement methodologies, and population health payment structures.
• Strong leadership, collaboration, and data analytics skills; ability to drive process improvements and financial stewardship.
• Experience with revenue cycle systems, EHRs, practice management systems, and Microsoft Office Suite.