Director of Revenue Cycle Management and Transformation

A growing, multi-specialty healthcare organization in New Jersey is seeking an experienced and strategic Director of Revenue Cycle Management & Transformation to lead end-to-end revenue cycle operations and drive meaningful organizational improvements.

This is an exciting opportunity for a hands-on, results-driven leader who can combine executive-level strategy with operational expertise, develop high-performing teams, and implement sustainable improvements across a complex healthcare environment.

The ideal candidate brings extensive healthcare revenue cycle experience, strong analytical capabilities, and a proven ability to transform processes, strengthen financial performance, and build accountable, collaborative teams.

Key Responsibilities

Revenue Cycle Strategy & Leadership

• Develop and execute revenue cycle strategies, operational priorities, and transformation initiatives in partnership with executive leadership.
• Establish performance scorecards, reporting standards, and measurable operational goals.
• Identify opportunities to improve financial outcomes, operational efficiency, and organizational scalability.
• Lead executive performance reviews, communicate key findings, and recommend actionable improvements.

Revenue Cycle Operations & Financial Performance

• Oversee end-to-end revenue cycle operations, including billing, coding, claims submission, payment posting, accounts receivable, denials, appeals, collections, and cash reconciliation.
• Drive improvements in clean-claim rates, reimbursement accuracy, charge capture, timely filing, and accounts receivable performance.
• Ensure revenue integrity across professional, procedural, rehabilitation, facility, and ambulatory surgery center billing.
• Identify operational inefficiencies and implement sustainable solutions to improve financial performance.

Payer Relations, Reimbursement & Compliance

• Lead payer performance management, underpayment recovery, out-of-network reimbursement strategies, appeals, arbitration, and federal independent dispute resolution (IDR).
• Oversee coding compliance, audit processes, documentation standards, and corrective action initiatives.
• Collaborate with clinical and operational leadership to resolve documentation, authorization, and reimbursement challenges.
• Maintain strong compliance standards while protecting patient experience and organizational integrity.

Credentialing & Payer Enrollment

• Oversee provider credentialing, recredentialing, payer enrollment, and roster management.
• Partner with clinical teams, People Operations, and Finance to ensure provider billing readiness.
• Identify and resolve enrollment challenges that impact reimbursement and operational performance.

Systems, Process Improvement & Transformation

• Optimize practice management and electronic health record systems, reporting, workflows, work queues, automation, and operational functionality.
• Develop standardized operating procedures, controls, reporting tools, and accountability frameworks.
• Manage vendor performance and ensure alignment with organizational goals.
• Lead process improvement initiatives that support efficiency, accuracy, and long-term growth.

Team Development & Cross-Functional Collaboration

• Lead, mentor, and develop revenue cycle management personnel and assigned team members.
• Establish clear performance expectations, provide coaching, and foster professional development.
• Build strong relationships with providers, clinical leaders, Finance, and operational teams.
• Promote a collaborative, accountable, and supportive team environment.

Required Qualifications

• 8+ years of progressive healthcare revenue cycle management experience.
• Minimum 3 years of leadership experience managing teams, major RCM programs, or revenue cycle functions.
• Proven success improving or transforming revenue cycle operations, workflows, performance reporting, and financial outcomes.
• Strong understanding of medical billing, coding, claims management, denials, accounts receivable, collections, reimbursement, credentialing, and payer enrollment.
• Direct experience within orthopedics, spine, pain management, rehabilitation, ambulatory surgery centers, or comparable multi-site specialty healthcare organizations.
• Experience managing out-of-network claims, appeals, arbitration, payer escalations, and federal IDR processes.
• Strong analytical, financial reporting, problem-solving, and organizational skills.
• Demonstrated ability to develop leaders, manage teams, and collaborate effectively with executive and clinical stakeholders.
• Ability to maintain regular onsite leadership presence and travel between affiliated locations as needed.

Preferred Qualifications

• Advanced experience with eClinicalWorks, including reporting, workflow optimization, and operational functionality.
• Experience overseeing both professional and facility or ambulatory surgery center revenue cycles.
• Experience with clinical documentation improvement and coding education.
• Relevant professional credentials such as CPC, CPMA, CRCR, CHFP, HFMA, or equivalent.
• Bachelor's degree in Healthcare Administration, Business, Finance, Accounting, Health Information Management, or a related field. Significant relevant experience may be considered in place of a degree.

What Success Looks Like

The successful candidate will play a critical role in strengthening the organization's financial and operational performance by:

• Establishing clear, reliable revenue cycle performance metrics and reporting.
• Strengthening operational accountability and team effectiveness.
• Identifying opportunities to improve reimbursement, reduce denials, and optimize collections.
• Developing scalable workflows, processes, and internal controls.
• Building a sustainable revenue cycle transformation strategy that supports continued organizational growth.

Compensation & Work Arrangement

The position is also eligible for an annual incentive opportunity targeting 20% of eligible base earnings , subject to the organization's applicable incentive framework.

This is a hybrid leadership position requiring regular onsite presence at locations throughout New Jersey. Initial onboarding and integration will be primarily onsite, with the ongoing schedule determined by operational and business needs.

Why Consider This Opportunity?

This position offers the opportunity to take ownership of a critical business function within a growing healthcare organization.

The successful candidate will have the ability to influence organizational strategy, develop high-performing teams, implement meaningful operational improvements, and contribute directly to long-term financial and operational success.

If you're an experienced revenue cycle leader ready to take on a strategic, high-impact leadership opportunity, we encourage you to apply.

Pay: $130,000.00 - $165,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Health insurance
• Paid time off

Work Location: In person