Director of Revenue and Contract Management

Brockton Area Multi-Servi•Brockton, MA

2d•$110,000 - $125,000•Hybrid

About The Position

The Director of Revenue Cycle and Contract Management provides enterprise leadership for BAMSI’s revenue lifecycle, from contract interpretation and service documentation through billing, collection, reconciliation, and financial reporting. Reporting to the Chief Financial Officer, the director is accountable for maximizing timely and accurate revenue from Massachusetts state agencies, including the Department of Developmental Services and Department of Mental Health, as well as MassHealth, commercial insurers, managed-care entities, and other third-party funders. The director establishes reliable controls connecting contracts, authorizations, services delivered, claims, cash receipts, accounts receivable, and the general ledger. The role works closely with the CFO, Controller, program operations, clinical leaders, contracting, compliance, information technology, and external funders to reduce revenue leakage, resolve denials and underpayments, improve cash flow, and support accurate revenue recognition in accordance with contract terms and generally accepted accounting principles.

Requirements

Bachelor’s degree in accounting, finance, business administration, healthcare administration, or a related field.
At least seven years of progressively responsible experience in revenue cycle, reimbursement, billing, accounts receivable, contract finance, or revenue accounting, including at least three years in a leadership or supervisory capacity.
Demonstrated experience with third-party billing and collection processes, including claim submission, remittance posting, denial resolution, aging management, and payer follow-up.
Experience managing and reconciling government contracts, grants, or publicly funded human-services or healthcare revenue.
Strong working knowledge of GAAP, revenue recognition, internal controls, month-end close, account reconciliation, and audit support.
Advanced analytical and spreadsheet skills, with the ability to work across financial, billing, contract, and operational systems.
Ability to interpret complex contracts and payer requirements, communicate findings clearly, and influence action across departments.
Demonstrated sound judgment, attention to detail, confidentiality, integrity, and ability to manage competing deadlines.

Nice To Haves

CPA, MBA, MHA, or another relevant graduate degree or professional credential.
Revenue-cycle leadership experience in a Massachusetts nonprofit human-services, behavioral-health, developmental-services, healthcare, or community-based organization.
Direct experience with Massachusetts DDS, DMH, MassHealth, managed-care organizations, and commercial insurance billing or funding arrangements.
Experience with cost-reimbursement, unit-rate, grant, and performance-based contracts and related closeout or cost-reporting requirements.
Experience implementing billing, electronic health record, enterprise resource planning, contract-management, or business-intelligence tools.

Responsibilities

Lead monthly revenue close activities for government contracts, grants, fee-for-service programs, and third-party payers, and provide revenue schedules to the CFO and Controller.
Reconcile services delivered, billing system activity, remittances, cash receipts, accounts receivable, deferred or unearned revenue, contract balances, and general-ledger revenue accounts.
Evaluate contract terms, funding conditions, rate structures, and service data to support revenue timing and classification.
Develop estimates and supporting schedules for earned but unbilled revenue, contractual allowances, denials, reserves, write-offs, and other revenue adjustments.
Investigate variances among contracted amounts, authorized units, services delivered, invoices or claims, payments, and recorded revenue, and drive resolution.
Maintain auditable documentation and standardized controls for revenue calculations, reconciliations, journal-entry support, and balance-sheet substantiation.
Prepare revenue-cycle reports, dashboards, and executive-level presentations; analyze billing trends, reimbursement issues, and collection performance.
Maintain a centralized inventory of active funding agreements, amendments, rates, service models, billing rules, reporting obligations, renewal dates, and key contacts.
Interpret financial and billing provisions in public funding agreements, including unit-rate, cost-reimbursement, allocation-based, and performance-based arrangements.
Partner with operational leaders to ensure staffing, census, utilization, authorizations, service documentation, and program activity support complete and accurate billing.
Monitor contract utilization, spending plans, encumbrances, amendments, rate changes, funding limits, and closeout requirements; identify underutilization and revenue risk.
Prepare or coordinate funder invoices, expenditure reports, reconciliations, cost reports, and other required financial submissions.
Serve as the principal Finance contact for revenue-related funder inquiries, discrepancies, audits, payment delays, and contract closeouts.
Oversee the end-to-end third-party revenue cycle, including eligibility and authorization controls, charge capture, coding interfaces, claim submission, remittance posting, denial management, follow-up, collections, and appeals.
Establish billing calendars and work queues to support timely submission of clean claims and invoices within payer and contract deadlines.
Monitor payer enrollment, credentialing dependencies, fee schedules, authorization requirements, claim edits, timely-filing limits, and payer-rule changes.
Analyze denials, rejections, underpayments, aging, unapplied cash, and credit balances; assign corrective actions and escalate systemic barriers.
Direct collection activity for outstanding government and third-party receivables while maintaining professional relationships with funding partners.
Approve or recommend adjustments, refunds, write-offs, and reserve changes in accordance with BAMSI policy and delegated authority.
Oversee third-party billing activities, including electronic claim submission and payment reconciliation; maintain knowledge of Medicare, Medicaid, managed care, commercial insurance, and value-based reimbursement models.
Manage relationships with insurance carriers and payer representatives.
Design and maintain written procedures, segregation of duties, approval thresholds, reconciliation standards, and documentation requirements across the revenue cycle.
Ensure billing practices are supported by services rendered, required documentation, authorizations, contract terms, and applicable federal and Massachusetts requirements.
Partner with Compliance, Quality, Legal, and program leadership to investigate potential billing errors, overpayments, duplicate payments, and other revenue-integrity concerns, and coordinate corrective action.
Support annual financial audits, Uniform Financial Reports, funder reviews, cost reports, and other regulatory or contractual examinations by producing accurate schedules and documentation.
Monitor record-retention requirements and safeguard confidential financial and protected health information.
Develop dashboards and routine reports covering billed and unbilled revenue, days in accounts receivable, aging, denial rates, clean-claim performance, cash collections, contract utilization, write-offs, and forecast-to-actual results.
Translate revenue data into forecasts, risks, and recommended actions for the CFO, executive leadership, and program owners.
Partner with Information Technology and system owners to improve interfaces among electronic health records, billing platforms, contract data, banking activity, and the general ledger.
Lead root-cause analysis and process redesign to reduce manual work, prevent revenue leakage, accelerate cash collection, and improve data quality.
Establish data ownership, validation routines, and exception reporting for census, authorizations, rates, service units, claims, remittances, and receipts.
Lead, coach, and develop assigned billing, revenue, and accounts-receivable staff; set priorities, performance expectations, service standards, and cross-training plans.
Promote accountability, timely follow-through, customer service, continuous improvement, and ethical revenue stewardship.
Partner with Finance, Operations, Clinical Services, Contracts, Compliance, and Human Resources to clarify responsibilities and resolve revenue-related issues.
Educate program and administrative teams on operational practices, documentation, deadlines, and data quality required to secure reimbursement.
Participate in new-program, new-contract, payer, and system implementations to address billing, accounting, reporting, and control requirements before launch.