Director of Revenue Cycle Management

About this role

Summary

The Director of Revenue Cycle Management (RCM) is responsible for leading and optimizing Boulder Care's end-to-end revenue cycle operations to maximize cash collections, ensure compliant billing practices, and support sustainable financial performance. This role partners closely with Finance, Clinical Operations, Product, Technology, Compliance, and third-party vendors to improve processes, strengthen controls, and provide actionable financial insights.

The Director will directly supervise the Revenue Cycle Manager and provide strategic leadership over all aspects of patient billing, coding, collections, payer operations, revenue integrity, and revenue cycle analytics. The Director will also own the partnership with Candid and other technology vendors to optimize system functionality, automate workflows, and continuously improve the overall revenue cycle experience.

The position plays a critical role in supporting accurate financial reporting, improving key performance indicators, ensuring compliance with healthcare regulations and payer requirements, and supporting Boulder Care's continued growth.

Core Responsibilities

Revenue Cycle Leadership

• Provide strategic leadership and oversight of all revenue cycle functions, including:

• Charge capture

• Coding support

• Claims management

• Payment posting

• Denials management

• Appeals

• Collections

• Revenue integrity

• Develop and execute initiatives to improve revenue cycle performance, cash flow, and operational efficiency.

• Establish measurable goals and key performance indicators (KPIs) for the revenue cycle organization.

• Foster a culture of accountability, continuous improvement, and exceptional customer service.

• Serve as Finance's executive leader for revenue cycle strategy, providing recommendations to the Controller and executive leadership regarding reimbursement trends, payer performance, cash flow optimization, and revenue cycle risks.

Financial Performance

• Monitor revenue cycle performance through dashboards and analytics.

• Analyze trends impacting revenue, collections, denial rates, aging, reimbursement, and payer performance.

• Identify opportunities to improve net collections and reduce revenue leakage.

• Partner with Accounting during the monthly close process to support revenue recognition, accounts receivable valuation, allowance methodologies, and audit support.

• Support budgeting, forecasting, and financial planning related to revenue operations.

Revenue Integrity & Compliance

• Ensure billing and collection activities comply with:

• Federal and state healthcare regulations

• Medicare and Medicaid requirements

• Commercial payer contracts

• HIPAA

• Internal policies and procedures

• Maintain strong internal controls supporting accurate financial reporting and compliance with GAAP.

• Partner with Compliance and Legal on regulatory changes impacting reimbursement.

• Promote accurate documentation and billing practices that maximize compliant reimbursement.

Operational Excellence

• Evaluate workflows and implement process improvements utilizing Lean or other continuous improvement methodologies.

• Partner with Product, Engineering, and Technology teams to improve automation and system functionality.

• Maintain strong working relationships with Candid and other revenue cycle vendors to maximize system capabilities and operational efficiency.

• Oversee third-party billing vendors and outsourced revenue cycle partners.

• Ensure timely resolution of payer issues and escalated billing concerns.

Leadership & Talent Development

• Directly supervise the Revenue Cycle Manager.

• Coach, mentor, and develop revenue cycle leaders and staff.

• Establish performance expectations and conduct regular performance evaluations.

• Build succession plans and support employee development.

• Promote collaboration, accountability, and continuous professional growth across the revenue cycle organization.

Cross-Functional Collaboration

• Partner closely with:

• Accounting

• FP&A

• Clinical Operations

• Credentialing

• Provider Operations

• Compliance

• Product

• Engineering

• Support implementation of new payer contracts, clinical programs, and operational initiatives.

• Present revenue cycle performance, strategic initiatives, and operational metrics to Finance leadership and executive management.

Qualifications

Required

• 8+ years of progressive healthcare revenue cycle experience.

• 4+ years of leadership experience managing revenue cycle teams.

• Strong understanding of:

• Healthcare reimbursement methodologies

• Commercial insurance

• Medicare

• Medicaid

• Value-based reimbursement models

• Experience managing denials, collections, payer relationships, and revenue integrity initiatives.

• Strong financial acumen with the ability to interpret operational and financial metrics.

• Experience working with healthcare billing systems and electronic health records (EHRs).

• Excellent analytical, communication, leadership, and relationship management skills.

Preferred

• Bachelor's degree in Accounting, Finance, Healthcare Administration, Business Administration, or a related field.

• Experience with start ups, behavioral health, substance use disorder treatment, or value-based care.

• Experience utilizing Candid, Boulder Care's revenue cycle management platform, or similar web-based healthcare billing applications.

• Experience with Athenahealth, Salesforce, or similar healthcare platforms.

• Knowledge of ASC 606 revenue recognition concepts and the relationship between revenue cycle operations and GAAP financial reporting.

• HFMA Certified Revenue Cycle Representative (CRCR), Certified Healthcare Financial Professional (CHFP), or other relevant healthcare revenue cycle certifications

Physical Demands

This is a largely sedentary role; some job duties may require the ability to lift up to 10 pounds, bend and/or stand as necessary.

• Must be able to sit an

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