Senior Revenue Cycle Management Project Manager (Systems, Reporting, SLA experience)

Key Responsibilities

• Apply formal project management methodologies (Agile, Waterfall, Hybrid) to manage scope, timelines, budgets, and risks across complex front-, middle-, and back-end revenue cycle programs
• Lead cross-functional teams including clinical staff, billing specialists, IT professionals, and executive stakeholders
• Develop comprehensive project charters, work breakdown structures, and communication plans
• Monitor project milestones and deliverables, ensuring alignment with organizational strategic goals
• Manage and report on Service Level Agreements (SLAs), ensuring compliance with contractual obligations and performance metrics
• Identify operational bottlenecks and inefficiencies across the revenue cycle continuum
• Design and implement standardized workflows to increase efficiency and reduce errors
• Deploy automation solutions to streamline repetitive tasks and improve accuracy
• Conduct process mapping and gap analysis to identify improvement opportunities
• Champion change management initiatives to ensure successful adoption of new processes
• Analyze claim rejection and denial trends to identify root causes and systemic issues
• Direct targeted strategies to improve clean claim rates and accelerate reimbursement cycles
• Collaborate with coding and billing teams to address documentation deficiencies
• Implement denial prevention programs and appeal processes
• Monitor payer-specific requirements and adjust workflows accordingly
• Track and report on core Key Performance Indicators (KPIs) including:
  • Days in Accounts Receivable (A/R)
  • Net collection rates
  • Clean claim rates
  • Denial rates and appeal success rates
  • Point-of-service collections
  • Cost-to-collect ratios
• Generate routine executive reports and dashboards for senior leadership
• Develop comprehensive reporting frameworks to support data-driven decision-making
• Conduct variance analysis and recommend corrective actions
• Present findings and recommendations to C-suite executives and board members
• Act as a strategic liaison between clinical, financial, and IT departments
• Facilitate regular meetings with stakeholders to ensure alignment on revenue goals
• Translate complex financial and technical concepts for diverse audiences
• Build consensus among competing priorities and resource constraints
• Maintain transparent communication channels with all project participants
• Ensure all billing and coding practices adhere to federal, state, and payer regulations
• Stay current on regulatory changes including CMS guidelines, HIPAA requirements, and payer policies
• Oversee internal and external auditing processes to ensure compliance and accuracy
• Coordinate with compliance officers to address audit findings and implement corrective action plans
• Develop and maintain compliance documentation and standard operating procedures
• Apply certification knowledge in coding, billing, and auditing to ensure best practices
• Demonstrate proficiency with Careview and InnovAlone platforms
• Optimize Electronic Health Record (EHR) system configurations to support revenue cycle workflows
• Collaborate with IT teams on system implementations, upgrades, and integrations
• Exhibit strong system savvy to quickly learn and adapt to new technologies and platforms
• Evaluate and recommend revenue cycle management software and tools
• Ensure data integrity across multiple systems and platforms

Required Qualifications

• Bachelor’s degree in healthcare administration, Business, Finance, Health Information Management, or a related field required
• Minimum 10+ years of extensive hands-on management experience in healthcare revenue cycle management with demonstrated success leading large-scale projects or transformations
• Proven track record of managing enterprise-level revenue cycle initiatives from conception through implementation
• Experience with Careview and InnovAlone systems required
• Demonstrated expertise in reporting and managing Service Level Agreements (SLAs)
• Experience working in remote/distributed team environments
• Background in healthcare operations, finance, or health information management
• Certified Revenue Cycle Professional (CRCP), Certified Revenue Cycle Representative (CRCR), or similar revenue cycle certification required
• Certification in coding (CPC, CCS, or equivalent), billing, and/or auditing required
• Advanced proficiency with Careview and InnovAlone platforms (required)
• Exceptional system experience with ability to quickly master new technologies and software applications
• Proficiency in major Electronic Health Record (EHR) systems such as Epic, Cerner, Meditech, or Allscripts
• Advanced skills in data analytics tools including Tableau, Power BI, Microsoft Excel, or SQL
• Experience with revenue cycle management software and billing systems
• Strong understanding of medical coding (ICD-10, CPT, HCPCS) and billing regulations
• Familiarity with claims processing systems and clearing houses
• Expertise in developing and managing reporting frameworks and dashboards
• Demonstrated ability to manage and monitor Service Level Agreements (SLAs)
• Change management expertise with proven ability to drive adoption of new processes and technologies
• Attention to detail and accuracy particularly in financial and compliance matters