Director, Revenue Cycle (FQHC)

Centerstone•Nashville, TN

About The Position

The Director, Revenue Cycle (FQHC) provides strategic leadership, oversight, and optimization of revenue cycle operations across Centerstone's Federally Qualified Health Center services. The role serves as the organization's subject matter expert on FQHC reimbursement methodologies, regulatory requirements, payer relationships, and revenue integrity initiatives. The Director ensures compliance with HRSA, Medicare, Medicaid, and other applicable regulations while maximizing reimbursement, minimizing denials, and improving financial performance. The Director partners with operational, clinical, compliance, finance, and executive leaders to develop revenue cycle strategies that support organizational growth, operational excellence, and financial sustainability across multiple states. The position oversees internal operations and external vendors, analyzes performance, and supports initiatives such as new clinic locations, service-line expansions, acquisitions, and revenue cycle integrations.

Requirements

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field.
Seven or more years of progressive healthcare revenue cycle leadership experience.
Demonstrated expertise in Medicaid, Medicare, and managed care reimbursement programs.
Experience with financial reporting, performance analytics, and operational improvement initiatives.
Extensive knowledge of FQHC revenue cycle operations and reimbursement methodologies.
Strong understanding of HRSA compliance requirements and FQHC operational regulations.
Expertise in Medicare, Medicaid, managed care, PPS reimbursement, encounter billing, and wrap payment processes.
Knowledge of revenue cycle best practices, denial management, reimbursement optimization, and revenue integrity principles.
Ability to analyze complex reimbursement and financial performance data and implement strategic solutions.
Strong leadership, change management, team development, project management, problem-solving, and organizational skills.
Excellent written, verbal, and presentation communication skills, with the ability to build effective relationships with executive leadership, clinical leaders, finance teams, vendors, and payers.
Ability to manage multiple priorities in a dynamic healthcare environment.

Nice To Haves

Master's degree.
At least three years of revenue cycle leadership experience within an FQHC, Community Health Center, Rural Health Clinic, or similar ambulatory healthcare setting.
Experience leading multi-site and/or multi-state revenue cycle operations.
Experience managing vendor relationships and outsourced revenue cycle functions.
Familiarity with 340B program operations, compliance requirements, pharmacy billing, and revenue optimization strategies.
Professional certification such as HFMA, CRCR, CHFP, or a similar credential.

Responsibilities

Provide strategic leadership and oversight for patient registration, charge capture, coding, billing, collections, denial management, appeals, reimbursement, and accounts receivable.
Serve as the subject matter expert on FQHC reimbursement, including Medicare and Medicaid Prospective Payment Systems (PPS), encounter billing, and wrap payment processes.
Monitor federal and state regulatory changes affecting FQHC reimbursement and implement operational and billing process improvements.
Develop and execute strategies to improve cash flow, reduce denials, increase clean claim rates, and optimize reimbursement.
Lead the evaluation, development, and implementation of revenue cycle policies, procedures, and best practices.
Oversee internal revenue cycle operations and external vendors to ensure performance expectations are met.
Analyze revenue cycle metrics, including days in accounts receivable, denial and collection rates, payer trends, and reimbursement performance.
Collaborate with clinical, operational, compliance, and finance leaders to support accurate documentation, coding, charge capture, and billing.
Maintain knowledge of Medicare, Medicaid, commercial payer, and managed care reimbursement methodologies affecting FQHC operations.
Manage governmental and commercial payer relationships to resolve reimbursement issues, improve operations, and maximize revenue opportunities.
Lead denial prevention and appeals strategies to reduce revenue leakage and improve financial performance.
Oversee fee schedule maintenance and ensure appropriate reimbursement methodologies are applied across services.
Support growth initiatives, including new clinic locations, service-line expansions, acquisitions, and revenue cycle integrations.
Partner with finance leadership on cash reconciliation, forecasting, revenue integrity, month-end reporting, and financial analysis.