Full-Time
Director RCM Operations
Infinx
No salary listed
Spring, TX, USA
Hybrid
Hybrid work is preferred in Houston or New Orleans; travel of approximately 20–30% is required.
Bachelor's, Master's
Category
 Project & Program Management (1) |
|---|
Required Skills
Six Sigma
Data Visualization
Inventory Management
Financial analysis
Data Analysis
Requirements
- A bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field.
- At least 10 years of progressive experience in healthcare Revenue Cycle Management.
- Deep hands-on knowledge of end-to-end physician and/or ambulatory Revenue Cycle Management workflows.
- Strong experience across billing, payment posting, accounts receivable, denials, appeals, collections, and reimbursement processes.
- Demonstrated experience leading complex client implementations, operational transitions, or performance improvement initiatives.
- Proven ability to analyze inventory, volumes, productivity, staffing requirements, and operational capacity.
- Experience developing standard operating procedures, training frameworks, operational controls, and performance metrics.
- Demonstrated success resolving complex delivery issues and client escalations.
- A strong understanding of payer processes, reimbursement methodologies, denial management, and revenue cycle performance indicators.
- Deep Revenue Cycle Management domain expertise.
- Strong critical-thinking and structured problem-solving capabilities.
- Strong operational and financial analytical skills.
- Ability to translate client requirements into scalable operating solutions.
- Strong implementation and transition-management capabilities.
- Executive-level communication and presentation skills.
- Strong customer-facing and stakeholder-management capabilities.
- Ability to influence cross-functional teams without direct reporting authority.
- Strong understanding of operational performance metrics and analytics.
- Strong documentation, standard operating procedure, and knowledge-transfer capabilities.
- Ability to operate effectively across onshore and offshore teams.
- Strong change-management and escalation-management capabilities.
- Ability to work effectively in ambiguous, high-growth, and rapidly changing environments.
- Experience with major Revenue Cycle Management platforms, practice-management systems, electronic health record systems, payer portals, workflow tools, and reporting platforms.
- Ability to travel approximately 20–30% for strategic client implementations, operational workshops, training, and escalation support.
Responsibilities
- Lead Revenue Cycle delivery planning for strategic client implementations and complex operational transitions.
- Translate contract scope, client expectations, workflows, volumes, and service requirements into executable operating plans.
- Conduct operational discovery and validate assumptions before implementation.
- Perform detailed inventory analysis across accounts receivable, billing, denials, payment posting, charge entry, and related workflows.
- Develop effort estimates, productivity assumptions, staffing requirements, skill profiles, and capacity models.
- Identify operational risks, dependencies, access requirements, and implementation gaps before go-live.
- Establish implementation milestones, readiness criteria, ownership, and escalation pathways.
- Partner with Patient Access and Coding Strategic Delivery leads to ensure end-to-end alignment across the revenue cycle.
- Provide subject matter expertise across charge entry, claims submission and billing, payment posting, accounts receivable follow-up, denial management and appeals, collections, credit balances and refunds, payer follow-up, reimbursement workflows, and inventory management.
- Evaluate existing client workflows and recommend scalable, efficient operating models.
- Analyze payer behavior, aging trends, denial patterns, reimbursement issues, and revenue leakage opportunities.
- Support Operations teams with complex functional issues and critical client escalations.
- Recommend solutions based on operational data, root-cause analysis, and industry best practices.
- Validate scope, volumes, productivity benchmarks, staffing assumptions, and client expectations before launch.
- Support workforce planning, hiring profiles, candidate assessment, and staffing readiness.
- Define operational service levels, key performance indicators, quality expectations, turnaround times, and productivity standards.
- Ensure process documentation and standard operating procedures are complete and aligned with contractual requirements.
- Support development and validation of training programs, knowledge assessments, and operational readiness plans.
- Confirm system access, payer portal access, reporting requirements, workflow queues, and client dependencies.
- Partner with Product and Technology teams to validate product configuration and workflow readiness.
- Provide hands-on delivery leadership during strategic client go-lives.
- Establish and lead daily governance during critical implementation periods.
- Monitor production volumes, inventory, backlog, quality, productivity, turnaround time, and staffing utilization.
- Support production planning and workload prioritization.
- Coordinate resolution of operational, product, system, workflow, access, and training issues.
- Provide functional guidance to onshore and offshore Operations teams.
- Participate in client implementation and delivery meetings as needed.
- Maintain structured risk, issue, dependency, and action tracking.
- Escalate material risks with clear recommendations, owners, and recovery plans.
- Lead delivery assurance through the initial stabilization period for assigned strategic engagements.
- Monitor performance against agreed service-level agreements, key performance indicators, productivity, quality, and financial expectations.
- Conduct root-cause analysis for recurring operational issues and implement corrective action plans.
- Review staffing against actual production demand and recommend adjustments where appropriate.
- Identify training gaps and facilitate targeted retraining or knowledge reinforcement.
- Ensure standard operating procedures remain current as workflows evolve during implementation.
- Partner with Operations leadership to build independent delivery capability.
- Drive timely resolution of customer concerns and delivery escalations.
- Support account-level gross-margin improvement by identifying operational inefficiencies and staffing opportunities.
- Develop and execute a structured transition plan to the designated onshore or offshore Operations team.
- Ensure complete knowledge transfer, documentation, training, reporting, and ownership before handoff.
- Establish clear steady-state roles and responsibilities across Operations, Customer Success, Product, and support functions.
- Define exit criteria and validate operational readiness before Strategic Delivery ownership is reduced.
- Continue periodic delivery assurance reviews for strategic accounts following transition.
- Re-engage when material delivery risk, escalation, or performance deterioration is identified.
- Establish performance scorecards for strategic implementations and stabilization programs.
- Monitor and analyze key Revenue Cycle Management indicators, including days in accounts receivable, aging distribution, denial rates, clean claim rate, first-pass yield, collection efficiency, cash acceleration, productivity, quality, backlog, and turnaround time.
- Convert operational data into recommendations, corrective actions, and measurable improvement plans.
- Provide concise executive reporting on implementation status, risks, client impact, and required actions.
- Serve as a senior operational subject matter expert for strategic client engagements.
- Participate in implementation calls, operational reviews, monthly business reviews, quarterly business reviews, and escalation discussions as required.
- Partner closely with Customer Success to ensure client commitments are reflected accurately in operational delivery.
- Maintain alignment between client expectations, contractual commitments, product capabilities, and operational execution.
- Present solution-oriented recommendations rather than only identifying delivery problems.
- Support customer confidence through domain expertise, structured communication, and timely issue resolution.
- Partner with Product teams, including RCM+ and PA+, to align technology capabilities with client workflows.
- Identify opportunities for automation, artificial intelligence, workflow optimization, and reduction of manual effort.
- Translate operational pain points into clearly defined product requirements and improvement opportunities.
- Support testing, workflow validation, and implementation of new technology capabilities.
- Capture recurring operational issues that may warrant product or process redesign.
- Ensure complete and current standard operating procedures are developed for assigned strategic engagements.
- Build repeatable delivery playbooks and implementation standards.
- Facilitate knowledge transfer between client-facing, onshore, and offshore teams.
- Ensure critical knowledge is institutionalized rather than dependent on individual resources.
- Conduct post-implementation lessons-learned reviews.
- Translate lessons learned into improvements to standard operating procedures, training materials, workflows, implementation frameworks, and product capabilities.
- Partner with offshore Operations leadership to establish scalable delivery models for strategic engagements.
- Support offshore readiness, skill development, staffing, training, and knowledge transfer.
- Ensure alignment between onshore and offshore teams on scope, workflows, performance expectations, and escalation protocols.
- Provide domain guidance during complex production or client situations.
- Facilitate transition of work to offshore teams where appropriate while protecting service quality and client expectations.
- Support development of standardized operating rhythms across geographies.
- Identify recurring delivery gaps across strategic accounts and develop repeatable solutions.
- Promote standardization across client implementations while accommodating legitimate client-specific requirements.
- Develop reusable templates, checklists, dashboards, and delivery playbooks.
- Support development and continuous improvement of the Strategic Delivery operating framework.
- Identify opportunities to improve scalability, quality, productivity, customer satisfaction, and gross margin.
- Achieve strategic implementation readiness and go-live success.
- Support timely operational stabilization.
- Achieve service-level agreement and key performance indicator targets.
- Deliver quality and productivity performance.
- Improve accuracy of staffing and effort estimates.
- Reduce delivery escalations.
- Complete effective transition to steady-state Operations.
- Complete knowledge transfer and standard operating procedures.
- Support client satisfaction and delivery confidence.
- Improve operational scalability.
- Contribute to account gross-margin improvement.
- Identify and implement automation and process-improvement opportunities.
Desired Qualifications
- A master's degree in Healthcare Administration, Business Administration, or a related field.
- At least 5 years in a leadership, consulting, implementation, transition, or operational-transformation capacity.
- Experience working with global or offshore delivery teams.
- Experience partnering with Product and Technology teams on workflow automation or digital-transformation initiatives.
- Relevant certifications, such as Certified Revenue Cycle Representative or equivalent, Lean Six Sigma or process-improvement certification, and project-management or transition-management certification.
- Working knowledge of automation and artificial-intelligence applications within Revenue Cycle Management.
Infinx
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