Caravel Autism Health Logo

Caravel Autism Health

Senior Director, Revenue Cycle Management

Posted 12 Days Ago
Be an Early Applicant
Remote
Hiring Remotely in US
150K-190K Annually
Senior level
Remote
Hiring Remotely in US
150K-190K Annually
Senior level
Provide strategic leadership for end-to-end revenue cycle operations including authorizations, billing, AR, and collections. Optimize cash flow, ensure compliance with CPT/HIPAA, manage payer relationships, implement RCM automation and EHR enhancements, direct denial management and analytics, and lead/mentor billing and authorization teams to support organizational financial goals.
The summary above was generated by AI

The Senior Director Revenue Cycle  provides strategic oversight and leadership across the full spectrum of revenue operations. This includes designing and driving scalable workflows in authorizations, billing, accounts receivable, and collections to drive sustainable financial performance. By leveraging data-driven insights, the Senior Director, Revenue Cycle  steers organizational policy, ensures company-wide compliance, and leads a high-performing team to ensure operational goals align with broader corporate financial objectives and regulatory requirements.

Essential Functions:

Strategic Revenue Operations & Financial Stewardship

  • Executive Oversight: Provide strategic leadership for the end-to-end revenue cycle, including authorization procurement, billing, and accounts receivable management.
  • Yield Optimization: Implement company-wide strategies to reduce Days in A/R, improve cash flow, and maximize net collection rates.
  • Financial Integrity: Ensure the accuracy of payment postings, adjustments, and general ledger reconciliations to maintain high standards of fiscal transparency and audit readiness.

Authorization Governance & Clinical Integration

  • Continuity Strategy: Design and oversee robust ABA-specific authorization workflows to prevent revenue leakage and ensure uninterrupted patient care.
  • Cross-Functional Alignment: Lead collaborative initiatives between clinical, finance, and compliance departments to synchronize operational workflows with payer requirements.
  • Patient Financial Experience: Manage the strategy for private-pay invoicing and collections, balancing organizational financial performance with a supportive family-centered experience.

Payer Strategy & Advocacy

  • Relationship Management: Act as the primary escalation point and negotiator for high-level payer disputes, underpayment trends, and policy changes.
  • Regulatory Compliance: Govern the institutional application of CPT codes, modifiers, and payer-specific billing rules to ensure 100% compliance across all service lines.
  • Recovery & Revenue Protection: Develop proactive systems to detect and recover underpayments, ensuring the organization receives full contracted value for services rendered.

Advanced Analytics & Performance Intelligence

  • Data-Driven Leadership: Establish and monitor executive KPIs (e.g., Clean Claim Rate, First-Pass Resolution) to evaluate departmental health and report on organizational performance.
  • Business Intelligence: Leverage RCM data and EHR reporting tools to identify macro-trends in payer behavior and lag times, translating complex data into actionable business improvements.
  • Denial Management: Direct structured, trend-based denial prevention and appeals workflows to mitigate recurring systemic issues.

Systems Innovation & Organizational Growth

  • Scalability & Automation: Lead the continuous improvement of the RCM tech stack, leveraging automation and EHR enhancements to support rapid organizational scaling.
  • Change Management: Drive the implementation of new payer mandates and system upgrades, overseeing the change management and training required for successful adoption.
  • Departmental Development: Mentor and lead the billing and authorization teams, fostering a culture of high performance, accountability, and professional growth.

Qualifications:

Education: 

  • High school diploma / GED equivalent required
  • Bachelor’s degree in business administration, health-related discipline, or equivalent professional experience preferred

Experience:

  • Minimum of five years of healthcare, hospital, billing, and collection experience in a supervisory capacity. 
  • Extensive knowledge of technologies, specifically spreadsheet and word processing software and hospital and physician billing software. 
  • ABA experience preferred.
  • Experience with CentralReach preferred.
  • Experience with Medicaid billing for primary and secondary reimbursement
  • Experience with physician billing

Skills and Competencies:

  • Strategic focus, with the ability to identify and execute on key business strategies that will support attainment of overall organizational business objectives.
  • Ability to effectively lead, coach, manage, mentor and develop others, holding staff accountable as appropriate.
  • Strong organizational skills necessary to coordinate and direct the Billing and Authorization functions and related record keeping.
  • The analytical skills necessary to review patient accounts for outstanding debts and to apply discounts and administrative write-offs consistently and appropriately, prepare analytical forecasts, etc.
  • Effective communication skills needed to interact with other Managers, departmental staff, representatives from regulatory agencies and payers, physicians, and patients (in resolving problems).
  • Experience working with basic office machinery and equipment, including computers, copiers, fax machines, multi-line phone systems, etc.
  • Demonstrates initiative, with the ability to manage self and others. 
  • Exemplary customer service focus, with both internal and external clients.
  • Able to work both independently and be self-directed, as well as being able to perform in a team atmosphere. 
  • Displays professionalism and represents organization in a professional manner.
  • Ability to abide by ethical guidelines and policies, including strict adherence to confidentiality and HIPPA guidelines. 
  • Strong knowledge of HIPPA privacy and security rules and regulations.

Remote position--open to candidates in the following locations:

Idaho, Illinois, Iowa, Kansas, Michigan, Minnesota, Missouri, Tennessee, Texas, Wisconsin

Similar Jobs

Senior level
Information Technology
Lead product strategy for RCM solutions, enhance operational efficiency, collaborate across teams, and drive revenue growth in healthcare.
Top Skills: Data ScienceEngineeringHealthcare TechnologyProduct ManagementRcm OperationsRevenue Cycle Management
21 Minutes Ago
In-Office or Remote
73K-130K Annually
Senior level
73K-130K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Build and maintain Databricks datasets, SQL/Python analytical workflows, and governed semantic layers. Support AI agent enablement by curating knowledge, prompts, and metadata. Partner with business stakeholders to deliver insights, automate workflows, and ensure data governance, quality, and trusted metrics for self-service intelligence and executive reporting.
Top Skills: Azure OpenaiChatgptDatabricksDatabricks GenieGenerative AiGenie SpacesMicrosoft CopilotPrompt EngineeringPythonSQLUnity Catalog
21 Minutes Ago
In-Office or Remote
92K-164K Annually
Senior level
92K-164K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Perform complex analyses of large healthcare claims datasets to support Payment Integrity operations. Design, validate, and maintain production queries, reports, dashboards, and KPI frameworks. Lead root-cause analysis, data validation, and forecasting. Partner with business and technical stakeholders to translate requirements, monitor data quality and algorithm performance, and deliver actionable recommendations to improve operational outcomes and compliance.
Top Skills: ExcelFacetsIsysOracleQnxtSnowflakeSQLSQL Server

What you need to know about the NYC Tech Scene

As the undisputed financial capital of the world, New York City is an epicenter of startup funding activity. The city has a thriving fintech scene and is a major player in verticals ranging from AI to biotech, cybersecurity and digital media. It also has universities like NYU, Columbia and Cornell Tech attracting students and researchers from across the globe, providing the ecosystem with a constant influx of world-class talent. And its East Coast location and three international airports make it a perfect spot for European companies establishing a foothold in the United States.

Key Facts About NYC Tech

  • Number of Tech Workers: 549,200; 6% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Capgemini, Bloomberg, IBM, Spotify
  • Key Industries: Artificial intelligence, Fintech
  • Funding Landscape: $25.5 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Greycroft, Thrive Capital, Union Square Ventures, FirstMark Capital, Tiger Global Management, Tribeca Venture Partners, Insight Partners, Two Sigma Ventures
  • Research Centers and Universities: Columbia University, New York University, Fordham University, CUNY, AI Now Institute, Flatiron Institute, C.N. Yang Institute for Theoretical Physics, NASA Space Radiation Laboratory

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account