Senior Director Revenue Cycle Management

JOB DESCRIPTION

Job Title: Senior Director Revenue Cycle Management

Position Type: Full Time

Work Setting: Hybrid

Group/Division/Team: Revenue Cycle Management

Reports to: VP Revenue Cycle Management

FLSA: Exempt

About VaxCare

The healthcare system is complex, presenting challenges for everyone-patients, doctors, nurses, office managers, and billers alike. At VaxCare, we aim to streamline this complexity, eliminating unnecessary costs and confusion so that practices can focus on their important work: caring for patients. Our innovative solutions include a vaccine management and LARC access platform trusted by over 20,000 active providers nationwide. This service is powered by a multidisciplinary team of dedicated professionals who lead with integrity and a relentless drive to exceed expectations, bringing clarity and efficiency to the often-overwhelming world of healthcare.

The Position

The Senior Director of Revenue Cycle Management (RCM) will lead backend revenue cycle operations for a national vaccine administration organization operating across 44 states. This role is heavily focused on denial management, accounts receivable optimization, and scalable workflow design in a high-volume environment processing over 5 million claims annually.

The ideal candidate brings deep expertise in denial management operations, clearinghouse workflows, and the broader RCM technology ecosystem, coupled with a strong track record of driving process improvement and automation. This role will also require a working understanding of how billing platforms integrate with multiple partner EHR systems to support a distributed care delivery model.

KEY RESPONSIBILITIES

Revenue Cycle Operations

• Lead day-to-day operations across the full revenue cycle, including:
  • Patient registration and eligibility
  • Charge capture and coding
  • Claims submission and clearinghouse management
  • Payment posting, AR follow-up, and denial management
• Manage throughput and performance in a high-volume claims environment with a focus on accuracy, timeliness, and scalability
• Establish and monitor KPIs (e.g., clean claim rate, days in AR, denial rate, net collection rate)

Technology & Systems Optimization

• Serve as a strategic leader in RCM technology and systems, including EHRs, practice management systems, and clearinghouses
• Partner with IT and vendors to:
  • Design and optimize charge routing, payer logic, and claim edits
  • Implement automation, AI, and workflow tools to improve efficiency
  • Lead system upgrades, integrations, and process redesign initiatives

Denials & Payer Strategy

• Drive enterprise denial management strategy:
  • Root cause analysis and remediation
  • Payer-specific workflow optimization
• Partner with payer contracting and compliance teams to ensure alignment with:
  • Vaccine billing requirements (including CMS, state Medicaid variations, and commercial payer policies)
  • Timely filing and documentation standards

Compliance & Regulatory Oversight

• Ensure adherence to federal and state billing regulations across 44 states
• Maintain audit-ready processes for CMS, Medicaid, and commercial payer requirements
• Oversee compliance related to vaccine administration billing, including counseling, preventive services, and modifier usage

Leadership & Team Development

• Lead and develop high-performing RCM teams (onshore/offshore as applicable)
• Establish accountability through clear performance expectations and regular reporting cadence
• Drive continuous improvement culture focused on scalability and quality

Cross-Functional Collaboration

• Partner with clinical operations, finance, IT, and external vendors to align revenue cycle strategy with organizational growth
• Support executive leadership with reporting, forecasting, and decision support related to revenue performance

Experience & Qualifications

Education

• Bachelor's degree in healthcare, business, health information management, or a related field
• Master's degree preferred

Experience

• 7+ years of progressive experience in Revenue Cycle Management, including leadership roles
• Demonstrated success managing operations in a high-volume environment
• Deep understanding of:
  • Medicare, Medicaid, and commercial payer billing
  • Denial management and AR optimization
  • End-to-end RCM workflows
• Strong experience with RCM technology platforms, including:
  • EHR systems
  • Clearinghouses ()
  • Revenue cycle analytics and reporting tools
• Proven ability to lead operational transformation and implement scalable process improvements

Preferred Qualifications

• Experience in vaccine administration, outpatient services, or high-throughput preventive care models
• RCM Consulting experience with exposure to multi-client or multi-state environments
• Experience managing multi-state regulatory complexity

COMPETENCIES: CORE TO ALL POSITIONS AT VAXCARE

We Live (and Work) by Our Values:

- Building a team culture founded on trust, collaboration, and delivery excellence

- Belief in Something Bigger than Ourselves - Capacity to derive meaning from a larger purpose

- Humility as a Posture of Learning - Burning curiosity to learn without ego

- Adaptability & Embracing Change - Nimbleness & ready to seize new opportunities

Additional "Must Haves":

- Dependability - Must be able to meet deadlines, work independently, maintain focus, & punctual

- Interpersonal Skills - Builds strong relationships & contributes to a positive work environment.

- Computer Skills - Skilled with computers, learns new tools quickly.

- Ethics - Honest, accountable, maintains confidentiality.

Other Responsibilities

• Commute to Office (if applicable): Must be able to commute to and from the corporate office for each scheduled shift.
• Prolonged sitting or standing: Team members must be able to remain in a stationary position for extended periods, as the majority of work involves sitting or standing at a computer or workstation.
• Repetitive motions: Significant use of the hands, wrists, and fingers is required for tasks like typing, using a computer mouse, and handling paperwork.
• Visual acuity: This job requires the ability to view a computer screen and read documents for extended periods.
• Communication: Team members must be able to clearly express and exchange ideas in English to effectively communicate with customers and co-workers.
• Occasional lifting: Many office-based jobs specify the ability to occasionally lift or move up to 10-20 pounds to handle supplies or equipment.