VP, RCM Business Operations

Job Description

This individual will be responsible for helping coordinate the day-to-day execution of all RCM functions, working with the Chief Revenue Officer (“CRO”) and the other RCM Vice Presidents to optimize performance, ensure proactive communication with practices, manage risks and issues along with the overall OO RCM team. This role will also work with the CRO to manage the operational infrastructure within RCM to support continued growth through practice acquisition and integration.

In addition, this individual will drive development, production and communication of KPI’s and metrics usage across the RCM platform.

• 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.
• Coordinate internal RCM team operations – including leading planning for and leading leadership meetings, managing risk and issues log.
• With the CRO, coordinate the various end-to-end revenue cycle operations including patient access, prior authorization, coding, charge capture, billing, A/R follow-up, denial management, and payment posting.
• 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 One Oncology operations.
• Ensure timely communication and coordination with other internal One Oncology teams such as Operational Regional Leadership, Accounting, Revenue Recognition, FP&A and the Executive Team of One Oncology.

• 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.
• Assist the other RCM VP’s in hiring, training, and monitoring of employees joining the Corporate One Oncology 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.
• Assist other RCM VP’s to implement internal controls and QA/QC processes around clinical documentation, coding accuracy, and claim submission.

Other duties as assigned to help drive our mission of improving the lives of…