RCM & Compliance Manager

Overview

Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state’s most vulnerable and underserved residents.

Founded in 1999, we’ve grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women’s health to endocrinology and psychiatry. We also provide nursing home support, care management, and in‑home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in‑person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.

We’re looking for talented, motivated individuals to join our growing team. Whether you’re a medical provider, administrator, or operations professional, there’s a career here for you. Join us in making a real difference in the health of our community.

Position Title
: RCM & Compliance Manager

Department
:
Nursing Home & Hospitalist Divisions

Job Summary
:
Essen Health Care is looking for a results driven RCM & Compliance Manager to lead and strengthen revenue cycle operations and regulatory compliance across our Nursing Home and Hospitalist divisions. This is not a back office support role. It is a strategic leadership position where you will directly influence how Essen captures revenue, maintains documentation integrity, and upholds the highest standards of care quality.

You will serve as the bridge between clinical documentation and financial performance, making sure our providers are documenting accurately, our claims are clean, and our compliance posture protects both patients and the organization. Reporting to senior leadership, this role carries real ownership and visibility across divisions.

At Essen, our mission is to innovate the healthcare delivery system and provide the most vulnerable communities access to the highest quality care. This role is essential to making that mission financially sustainable.

E&M Documentation & Compliance Oversight

• Conduct regular E&M documentation audits across nursing home and hospitalist providers to ensure accuracy, completeness, and alignment with CMS guidelines.
• Identify documentation gaps, upcoding/downcoding trends, and provider specific patterns that require targeted education or corrective action.
• Develop and deliver provider training on E&M coding requirements, medical necessity standards, and documentation best practices for long term care and inpatient encounters.
• Monitor regulatory changes related to E&M coding (including split/shared visit rules) and update internal compliance protocols accordingly.

Care Quality Audits

• Lead and conduct care quality audits across nursing home facilities and hospitalist service lines, evaluating clinical documentation against established quality benchmarks.
• Collaborate with medical directors, nursing leadership, and clinical teams to translate audit findings into actionable improvement plans.
• Track and trend audit results over time, reporting outcomes to senior leadership with clear recommendations for operational and clinical improvements.
• Ensure audit processes meet or exceed CMS Conditions of Participation, state survey readiness standards, and internal quality benchmarks.

Revenue Cycle Management (RCM)

• Oversee and improve RCM workflows from claims submission through final adjudication, with a focus on reducing denials and accelerating collections.
• Review and QA claims submissions for accuracy before release, ensuring proper coding, modifiers, and supporting documentation are in place.
• Lead denial management and appeals processes, conducting root cause analysis on denial trends and…