Senior Director RCM

Senior Director Revenue Cycle Management Job Description

Job Title: Senior Director Revenue Cycle Management

Position Type: Full Time

Work Setting: Office (Downtown Orlando)

Group/Division/Team: Revenue Cycle Management

Reports to: VP Revenue Cycle Management

FLSA: Exempt

The healthcare system is complex, presenting challenges for everyone—patients, doctors, nurses, office managers, and billers alike. At Vax Care, 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.

• 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)
• 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

• 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

• 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

• 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

• 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

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

• 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
• Stron…