VP, RCM Business Operations

Responsibilities

• Work closely with the CRO and the other RCM VP’s to coordinate delivery of high-quality RCM services to practices including timely and proactive communication to practice leadership.
• Develop, monitor, improve and communicate KPIs such as days in A/R, day sales outstanding (DSO’s), clean claim rate, denial rate, and cash collections; develop dashboards and reporting cadence for executive visibility.
• Embed the KPI’s into everyday RCM operations such that each RCM team assesses performance based on these KPI’s.
• Develop action plans and work alongside the other RCM VP’s to constantly drive down DSO’s, improve collections, coordinate RCM responses to external, macro-economic challenges such as vendor issues, government actions, or payor actions.
• Cook up internal RCM team operations – including leading planning for and leading leadership meetings, managing risk and issues log.
• Coordinate internal RCM team operations – including leading planning for and leading leadership meetings, managing risk and issues log.
• Oversee specialty-specific workflows such as: Oncology: Infusion and drug billing (e.g., J-codes, NDC mapping), prior authorization for high-cost therapies, Medicare Part B compliance. Urology: Procedure bundling, surgical authorization, and device billing. Surgery: Global periods, modifier usage, inpatient/outpatient billing distinctions.
• Develop and maintain a proactive approach for RCM to stay ahead of issues or risks before they impact practice or OneOncology operations.
• Ensure timely communication and coordination with other internal OneOncology teams such as Operational Regional Leadership, Accounting, Revenue Recognition, FP&A and the Executive Team of OneOncology.
• Support the development and execution of RCM strategy aligned with organizational goals, payer trends, and reimbursement models.
• Evaluate and optimize technology platforms (EHR/PM, clearinghouse, AI, automation tools, BI reporting).
• Collaborate closely with finance, clinical operations, IT, compliance, and managed care teams to ensure cohesive revenue cycle integration during onboarding of new practices and service lines.
• Manage a team of RCM leads based on team needs.
• Work alongside the other RCM VP’s to build a performance-based culture based on accountability, reliability, process excellence, and continuous improvement.
• Aid the other RCM VP’s in hiring, training, and monitoring of employees joining the Corporate OneOncology RCM team.
• Work with other RCM VP’s to ensure adherence to CMS, OIG, HIPAA, and payer specific regulations across specialties.
• Partner with Compliance and the other RCM VP’s to manage and communicate audits (internal and external), corrective action plans, and payer escalations.
• Aid other RCM VP’s to implement internal controls and QA/QC processes around clinical documentation, coding accuracy, and claim submission.

Qualifications/Competencies

• Bachelor’s degree in Healthcare Administration, Business, or related field required, Master’s degree preferred.
• 10+ years of progressive leadership experience in RCM, with at least 5 years in a senior leadership role overseeing multi-specialty revenue cycle functions required.
• Prior experience in supporting or leading RCM functions in a large organization is required.
• Experience supporting a growing MSO, large physician group, or PE-backed healthcare platform required.
• Experience integrating newly acquired practices into a centralized RCM function preferred.
• Familiarity with PM/EHR systems such as OncoEMR, NextGen, eCW, Athena, EPIC, etc preferred.
• Customer/client service approach to every activity.
• Strategic thinker with hands-on operational execution capability.
• Strong financial acumen and ability to tie revenue cycle performance to enterprise-level goals.
• Excellent leadership, communication, and change management skills.
• Strong organizational skills and ability to work across multi-function organizations.
• Ability to work with cross functional colleagues at the same executive level to accomplish objectives.
• Ability to work in a high growth environment with regularly changing priorities.
• Demonstrated ability to assess dynamic situations and cut through the noise to assess and drive priorities.
• Data-driven mindset with a commitment to process excellence and compliance.
• Ability and willingness to deep dive into claims, denials, patient authorizations to help guide team on focus areas.