Director Revenue Cycle Management

USHP•Rockville, MD

6d•Remote

About The Position

US Health Partners (“USHP”) seeks to redefine high-quality specialty care in the United States and establish a high-performing, technology-enabled care delivery platform. USHP is partnering with the country’s leading physicians to build a comprehensive, out-patient focused specialty care network targeting the nation’s cardiovascular concerns. Our physician-led organization is passionate about supporting exceptional care and enriching the lives of patients across the United States. We envision the opportunity to create a scaled, cutting-edge, technology-enabled healthcare services platform that leverages a value-based delivery model. The Director, Revenue Cycle Management is a senior leadership role responsible for driving enterprise-wide revenue cycle performance across a multi-state healthcare organization. Reporting to the VP of Revenue Cycle, this leader oversees end-to-end RCM operations—from charge capture and coding through claims submission, denial management, and collections—for affiliated practices. This role requires a strategic leader and hands-on operator with cardiovascular RCM expertise, a command of multi-state payer and regulatory environments, and a proven track record of delivering measurable financial outcomes in complex, multi-site healthcare organizations.

Requirements

Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field required; Master’s degree (MHA, MBA, or equivalent) preferred.
Minimum of 7 years of progressive revenue cycle experience in a physician group or health system setting, with at least 3 years in a director-level or equivalent leadership role.
Demonstrated experience managing RCM operations across multiple states and multiple practice sites simultaneously.
Strong working knowledge of Medicare and Medicaid billing rules, commercial payer requirements, and prior authorization processes relevant to cardiovascular or specialty physician practice settings.
Proficiency with practice management systems; experience with NextGen Enterprise PM strongly preferred.
Proven ability to lead and develop teams, manage cross-functional initiatives, and communicate effectively with both operational staff and executive leadership.
Revenue Cycle Expertise: Comprehensive knowledge of end-to-end physician billing operations, including charge capture, coding, claims processing, denial management, and collections across multiple payer types.
Strategic Leadership: Ability to translate organizational goals into operational plans, build high-performing teams, and drive results across a distributed, multi-site workforce.
Analytical Acumen: Skilled in interpreting financial and operational data, identifying trends and root causes, and developing data-driven action plans to improve KPIs such as net collection rate, AR days, and denial rates.
Communication and Collaboration: Effective communicator across all organizational levels, from front desk staff to board-level stakeholders; capable of translating complex billing and regulatory information into clear, actionable guidance.
Regulatory and Compliance Knowledge: Up-to-date understanding of federal and state healthcare billing regulations, CMS guidelines, HIPAA requirements, and payer-specific policies applicable to multi-state physician practice operations.
Technology Proficiency: Hands-on experience with practice management and billing systems; comfort with data reporting tools and ability to leverage technology to drive workflow efficiency and financial transparency.

Nice To Haves

Master’s degree in Healthcare Administration, Business Administration, or a related field.
Direct experience with cardiovascular or cardiology-specific billing, including nuclear cardiology, cardiac PET, echocardiography, and invasive/interventional procedure coding.
Hands-on experience with NextGen Enterprise PM system administration.
Experience working in a private equity–backed or high-growth healthcare organization with post-acquisition integration responsibilities.
Professional certification in healthcare billing or revenue cycle management (e.g., CRCR, CPC, CPMA, or equivalent).

Responsibilities

Provide strategic and operational leadership for all revenue cycle functions across affiliated cardiology practices, ensuring standardized workflows, consistent performance metrics, and alignment with enterprise financial goals.
Oversee end-to-end RCM operations including charge capture, coding compliance, claims submission, payment posting, denial management, and patient collections across all practice locations and financial classes.
Direct a team of regional RCM managers and establish clear performance expectations, conduct regular evaluations, and support a culture of accountability and continuous improvement.
Monitor and report on key performance indicators including net collection rate, days in AR, first-pass claim acceptance rate, denial rate by payer and category, and prior authorization approval rates; present findings and remediation plans to senior leadership on a regular cadence.
Lead prior authorization program oversight, including workflow design, task management configuration in NextGen Enterprise PM, escalation protocols, and tracking of authorization lag and denial impact across practices.
Serve as the organizational point of escalation for complex claims, payer audits, and contract-related disputes.
Ensure compliance with Medicare, Medicaid, and commercial payer billing requirements across all operating states, including incident-to billing rules, radiopharmaceutical (HCPCS) billing guidelines, and applicable CMS policies for cardiovascular services.
Optimize NextGen Enterprise PM configurations, examples include: financial class setup, claim scrubber rules, memorized reports, adjustment transaction codes, and BBP module workflows; partner with IT and vendor support on system enhancements and issue resolution.
Support revenue cycle integration activities for newly acquired practices, including workflow harmonization, system onboarding, staff training, and transition-period performance monitoring.
Perform other duties as assigned by the VP of Revenue Cycle or senior leadership.
This position has direct supervisory responsibility over regional RCM Managers across affiliated practices. The Director is responsible for hiring, onboarding, performance management, coaching, and, when necessary, progressive disciplinary actions for all direct and indirect reports within the revenue cycle department. This role also provides functional oversight of front-end staff performing scheduling, insurance verification, and authorization tasks in collaboration with practice administrators.