Director of Revenue Cycle Management
About The Position
The Director of Revenue Cycle is responsible for overseeing front-end revenue cycle functions to ensure accurate, timely, and compliant reimbursement for services. This role supervises Revenue Cycle Specialists and leads front-end financial processes including eligibility verification, funding assignment, and authorization management. In a behavioral health and Centralized Receiving System (CRS) environment, the Director of Revenue Cycle plays a critical role in ensuring proper alignment between clinical services, funding sources (e.g., Medicaid, DCF/Managing Entity, grants), and billing practices. This position works in close collaboration with Operations, Resource Navigators and the Controller to ensure seamless coordination between front-end processes and downstream billing functions, while maintaining a clear separation of responsibilities. This position will also oversee contract/grant billing functions to maximize revenue integrity and compliance.
Requirements
- Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required
- 5+ years of experience in healthcare revenue cycle management
- Prior supervisory experience required
- Strong knowledge of: Medicaid, Medicare, and managed care billing
- Strong knowledge of: DCF/Managing Entity funding models
- Excellent analytical and problem-solving skills
- Strong leadership and team development abilities
- Ability to interpret data and drive performance improvements
- Effective communication and cross-functional collaboration
Nice To Haves
- Experience in behavioral health, nonprofit, or DCF-funded environments strongly preferred
- Experience managing outsourced billing vendors preferred
Responsibilities
- Oversee front-end and revenue cycle functions, including: Eligibility verification, Authorization management, Funding assignment
- Ensure services are billed to the correct payer source (Medicaid, insurance, DCF/CFBHN, grants)
- Supervise and support Revenue Cycle Specialist and UM Supervisor
- Provide training, coaching, and performance management
- Establish clear expectations, workflows, and accountability
- Foster a culture of accuracy, compliance, and continuous improvement
- Ensure intake and eligibility processes support clean claims and proper funding assignment
- Maintain clear separation between clinical decision-making and financial determination
- Collaborating with Clinical Leadership and Resource Navigators to align workflows
- Ensure adherence to: HIPAA, Medicaid/Medicare regulations, DCF/CFBHN guidelines
- Maintain audit readiness and support internal/external audits
- Identify and mitigate revenue and compliance risks
- Partner with (healthcare) Clinical leadership, CRS/Access teams, Resource Navigators, Finance department
- Ensure alignment between service delivery, documentation, and reimbursement
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What This Job Offers
Job Type
Full-time
Career Level
Director
