Job Duties/Responsibilities:
Provide overall leadership and strategic direction for the Enterprise department.
Define and implement long-term departmental strategies aligned with organizational objectives and growth plans.
Oversee multi-layer leadership teams (Senior Managers, Managers, Process Leads, and Client Account Leads) and ensure accountability across service delivery.
Own financial outcomes, including revenue performance, client profitability, cost optimization, budgeting, and financial stewardship.
Drive business growth by identifying expansion opportunities, supporting new client acquisitions, and strengthening strategic partnerships across existing accounts.
Serve as the executive sponsor for key client relationships, ensuring long-term partnership success, client retention, and achievement of contractual commitments.
Lead strategic client governance, including executive escalations, Quarterly Business Reviews (QBRs), Year-to-Date (YTD) performance reviews, contract renewals, and business growth discussions.
Monitor and drive performance across all RCM functions, including charge posting, payment posting, accounts receivable (AR), denials management, reporting, and client governance.
Review AHT vs. FTE utilization, workforce capacity, and operational efficiency metrics, implementing optimization strategies to improve productivity and scalability.
Establish and monitor operational governance frameworks to ensure effective decision-making, performance management, and accountability across all leadership levels.
Own risk management and business continuity planning, ensuring proactive identification and mitigation of operational, financial, and delivery risks.
Ensure compliance with HIPAA, ISMS, QMS, payer regulations, client requirements, and other applicable regulatory standards.
Drive adoption of automation, analytics, AI/GenAI, and BOT solutions to enhance operational efficiency, scalability, and customer experience.
Foster innovation, leadership development, succession planning, and organizational capability building across the department.
Collaborate with Finance, Compliance, HR, Technology, and other cross-functional teams to support budgeting, audits, workforce planning, and digital transformation initiatives.
General Responsibilities
Promote a culture of excellence, innovation, accountability, and client-first delivery.
Ensure transparent communication with clients and internal leadership.
Foster innovation, talent development, and succession planning within leadership layers.
Represent the department in executive forums, client summits, and industry events
Requirements
Required Qualifications:
Bachelor’s degree or higher (MBA, MHA, or equivalent strongly preferred)
15+ years of end-to-end RCM experience with at least 5+ years in senior leadership roles
Proven experience in managing large, multi-practice RCM operations across specialties
Strong financial acumen including P&L ownership, budgeting, cost optimization, and AHT vs. FTE management.
Experience in all specialty Revenue Cycle Management with strong understanding of reimbursement methodologies, payer policies, authorization requirements, denial management, and operational performance drivers. Preferred certifications: CRCS – Certified Revenue Cycle Specialist (AAHAM), CRCR – Certified Revenue Cycle Representative (HFMA), and Lean Six Sigma Black Belt (LSSBB), CSPR – Payment & Reimbursement, CSBI – Business Intelligence, CSPPM – Physician Practice Management (all HFMA), and PMP (PMI).
Required Skills:
Expertise in client governance, escalations, and executive-level communication
Strong knowledge of automation/AI in RCM (BOTs, analytics, PMS optimization)
Deep understanding of compliance standards (HIPAA, ISMS, QMS, payer regulations)
Exceptional leadership, strategic planning, and organizational development skills
Ability to influence and collaborate across executive, client, and cross-functional teams.
Deep understanding of reimbursement trends, payer regulations, and revenue optimization strategies.
Performance Metrics:
Financial Outcomes – Achieve departmental revenue targets with margins ≥ planned levels and deliver year-on-year cost optimization ≥5%.
RCM KPIs – Maintain collections ≥95%, AR aging <25 days, denials ≤6%, and clean claim rate ≥99% across practices.
Operational Efficiency – Improve AHT vs. FTE utilization by ≥10% annually through workforce planning and process optimization.
Client Governance – Ensure ≥95% client retention, ≥4.5/5 satisfaction scores, and on-time contract renewals.