Director of Revenue Cycle Management

Overview

The Director of Revenue Cycle Management is a key leader responsible for optimizing the financial performance of the organization’s physician billing and revenue cycle operations. Serving as a primary liaison with RCM Vendor, this position provides strategic oversight of revenue cycle activities and works collaboratively with internal and external stakeholders to maximize collections, improve operational efficiency, and ensure timely and accurate reimbursement.

The Director will lead and oversee complex, multi-state revenue cycle operations for a provider organization, with a strong focus on physician billing, payer relationships, credentialing, and regulatory requirements. This role will also support the establishment and expansion of revenue cycle operations in new states and serve as an Authorized Official with appropriate signatory authority on behalf of the organization.

The ideal candidate will bring extensive RCM leadership experience, a strong understanding of physician, Nurse Practitioner and Physician Assistant billing and reimbursement, demonstrated success managing multi-state operations, and the ability to develop and implement strategies that drive sustainable revenue growth and operational excellence.

This is a remote position. The salary range is $165,000 - $175,000.

AlignMed Partners is a national medical group dedicated to improving health outcomes among residents of skilled nursing and senior living facilities. Our physicians, nurse practitioners (NPs) and physician assistants (PAs) are supported by a clinical leadership team with a decades-long track record of excellence in post-acute and long-term care. At AlignMed, we believe in a better quality of life for all. Our mission is to elevate healthcare outcomes for our patients, providers, and partners.

In living out our mission, we embrace the following pillars in our day-to-day operations.

Responsibilities

• Revenue Cycle Management and Billing Analysis
• 1. Liaison with RCM Vendor: Act as the primary interface and liaison with our billing and collections partner (RCM Vendor) to ensure seamless communication, accountability, and performance tracking
• 2. Billing Analysis: Perform regular, comprehensive billing analyses to identify trends, mitigate collection declines, and optimize the collection lifecycle
• 3. Collections Optimization: Strategize and execute solutions to maximize clean collections, aiming for zero leakage and high-efficiency billing outcomes
• Multi-State Operations and State Expansion
• 1. TIN Establishment: Lead the creation and registration of new business entities and Taxpayer Identification Numbers (TINs) to facilitate corporate expansion
• 2. State Setup: Manage the setup of new remote practice operations in expansion states, coordinating legal, regulatory, and financial compliance
• 3. CMS & Portal Access: Serve as an authorized official with signatory authority and manage CMS account provisioning
• Payer Credentialing and Enrollment
• 1. Credentialing Leadership: Direct day-to-day credentialing operations, including provider credentialing, provider enrollment, and database management
• 2. Regulatory updates: Inform co-leaders of pertinent updates to payer credentialing and enrollment processes, regulations, and standards
• 3. Compliance: Ensure complete compliance with federal, state, and commercial payer regulations
• 4. Team Management: Manage and expand the internal payer credentialing team (including Credentialing Specialists) to scale for a projected growth of 50 to 100 new providers
• Candidate Screening and Background Verification
• 1. Compliance Screening: Perform Office of Inspector General (OIG) database screenings and other critical background checks to verify candidate eligibility to bill Medicare and Medicaid

Qualifications

• Experience
• ● Required: 8 to 10 years of senior-level Revenue Cycle Management (RCM) experience in healthcare operations
• ● Operational Scope: Proven experience managing RCM for a multi-state remote physician practice or provider group (rather than basic coding or billing tasks)
• ● Authorized Official Experience: Demonstrated success serving as an authorized official with signatory authority
• ● Expansion Success: Direct experience establishing new TINs and managing credentialing setups across multiple states
• Target Competencies and Preferred Skills
• ● Industry Benchmarks: Prior experience in large competitor organizations is highly desirable
• ● Regulatory Knowledge: Deep understanding of CMS accounts, Medicare billing eligibility, and credentialing standards
• ● Team Leadership: Strong track record of managing and scaling internal credentialing specialists or billing staff

Responsibilities

• Revenue Cycle Management and Billing Analysis
• 1. Liaison with RCM Vendor: Act as the primary interface and liaison with our billing and collections partner (RCM Vendor) to ensure seamless communication, accountability, and performance tracking
• 2. Billing Analysis: Perform regular, comprehensive billing analyses to identify trends, mitigate collection declines, and optimize the collection lifecycle
• 3. Collections Optimization: Strategize and execute solutions to maximize clean collections, aiming for zero leakage and high-efficiency billing outcomes
• Multi-State Operations and State Expansion
• 1. TIN Establishment: Lead the creation and registration of new business entities and Taxpayer Identification Numbers (TINs) to facilitate corporate expansion
• 2. State Setup: Manage the setup of new remote practice operations in expansion states, coordinating legal, regulatory, and financial compliance
• 3. CMS & Portal Access: Serve as an authorized official with signatory authority and manage CMS account provisioning
• Payer Credentialing and Enrollment
• 1. Credentialing Leadership: Direct day-to-day credentialing operations, including provider credentialing, provider enrollment, and database management
• 2. Regulatory updates: Inform co-leaders of pertinent updates to payer credentialing and enrollment processes, regulations, and standards
• 3. Compliance: Ensure complete compliance with federal, state, and commercial payer regulations
• 4. Team Management: Manage and expand the internal payer credentialing team (including Credentialing Specialists) to scale for a projected growth of 50 to 100 new providers
• Candidate Screening and Background Verification
• 1. Compliance Screening: Perform Office of Inspector General (OIG) database screenings and other critical background checks to verify candidate eligibility to bill Medicare and Medicaid

Qualifications

• Experience
• ● Required: 8 to 10 years of senior-level Revenue Cycle Management (RCM) experience in healthcare operations
• ● Operational Scope: Proven experience managing RCM for a multi-state remote physician practice or provider group (rather than basic coding or billing tasks)
• ● Authorized Official Experience: Demonstrated success serving as an authorized official with signatory authority
• ● Expansion Success: Direct experience establishing new TINs and managing credentialing setups across multiple states
• Target Competencies and Preferred Skills
• ● Industry Benchmarks: Prior experience in large competitor organizations is highly desirable
• ● Regulatory Knowledge: Deep understanding of CMS accounts, Medicare billing eligibility, and credentialing standards
• ● Team Leadership: Strong track record of managing and scaling internal credentialing specialists or billing staff