Director, RCM Analytics & Insights

Job Description

The Director, RCM Analytics and Insights, is a newly created position responsible for leading the development, communication, and insights surrounding advanced RCM KPIs, analytics, and other metrics identifying actionable opportunities to optimize all aspects of RCM performance. This role will report to the Sr Director – Revenue but will be embedded with the RCM team with dotted line reporting to the Chief Revenue Officer. This position will be integral to the Company’s revenue recognition process as we more closely link RCM metrics to revenue recognition.

Responsibilities

• Serves as the primary RCM analytics and insights leader for the RCM organization working as a close advisor to the Chief Revenue Officer, other RCM leaders, and the Sr Director – Revenue.
• Lead RCM enterprise-wide analysis and trend assessments of registration, billing, denial, underpayment, and accounts receivable performance across multiple oncology practices to identify systemic root causes, emerging risks, and revenue optimization opportunities.
• This entails providing meaningful and timely KPIs and analytical data to the RCM leadership driving each of these areas.
• Partner with the overall analytics team to establish proactive monitoring and early-warning capabilities to identify adverse payer behaviors, denial trends, contract variances, and AR deterioration before financial impact occurs.
• Translate analysis and metrics into insights to support actionable strategies, operational priorities, and payer or practice-level escalations.
• Collaborate closely with the payer relations contracting team on complex, high-impact payer issues, supporting data-driven escalation, negotiation support, and resolution strategies.
• Develop advanced analytics and AI use cases within the RCM team (e.g., predictive denial risk, automation opportunities, root-cause clustering) to reduce preventable denials and manual rework.
• Develop standardized processes to drive efficiency in analyzing and reporting data and trends in a repeatable, consistent reporting format.
• Partner with RCM Operations, Revenue Integrity, IT, and vendors to develop system enhancements, configuration changes, workflow redesign, and process standardization based on insight findings.
• Support denial prevention strategies through detailed analysis of payer policies, contract terms, billing requirements, and coding behaviors, ensuring corrective actions are embedded upstream.
• Develop and provide RCM reporting, dashboards, and KPIs, ensuring data accuracy, consistency, and alignment with enterprise performance and financial goals.
• Champion data-driven decision making and insight maturity across the RCM organization in support of scalable growth and long-term financial sustainability.
• Perform additional responsibilities as assigned to support the organization’s mission of improving the lives of everyone living with cancer.

Qualifications

• Bachelor’s degree required; degree in Healthcare Administration, Finance, Analytics, Informatics, or a related field strongly preferred. Master’s degree a plus.
• 7-10 years of progressive experience in finance and healthcare data analytics; revenue cycle management operations or reimbursement oversight, preferably within an oncology or complex, multi-site healthcare environment.
• Prior experience in Radiation Oncology and/or Medical Oncology is a plus.
• Prior experience with HCPCS, ICD-10, and CPT coding, including their downstream impact on denials, underpayments, and AR performance.

Essential Competencies

• Proven ability to analyze and proactively identify enterprise-level systemic trends and root causes in the RCM space to support corrective actions with measurable financial and operational impact.
• Experience partnering with executive leadership, practice leadership, analytics, finance, contracting, payer engagement, billing vendors, and IT to resolve complex reimbursement challenges.
• A detail oriented and organized approach with a self-starter attitude.
• Strong analytical and strategic thinking skills, with experience leveraging advanced analytics, automation, and/or AI-driven insights to improve revenue cycle performance.
• Solid understanding payer policies, reimbursement methodologies, and regulatory requirements related to medical billing, including Medicare, Medicaid, and commercial payers.
• Demonstrated leadership experience, including guiding, mentoring, or managing analytics, insights, or operational RCM teams.
• Excellent communication skills with the ability to translate complex data and technical findings into clear, actionable insights for diverse stakeholders.
• Demonstrated professionalism, adaptability, and accountability, with the ability to operate independently and lead effectively in a geographically distributed work environment.
• High proficiency with enterprise reporting and analytics tools, including Microsoft Excel and related data analysis capabilities, as well as patient accounting, billing, and medical information systems.
• Enjoy working in a fast-paced environment with ever-changing priorities.