Director, Revenue Cycle (FQHC)

Centerstone•Nashville, TN

4d•$74,400 - $111,600

About The Position

The Director, Revenue Cycle (FQHC) provides strategic leadership, oversight, and optimization of revenue cycle operations across the organization’s Federally Qualified Health Center services. This role serves as the organization’s subject matter expert on FQHC reimbursement methodologies, regulatory requirements, payer relationships, and revenue integrity. The Director ensures compliance with HRSA, Medicare, Medicaid, and other applicable requirements while maximizing reimbursement, reducing denials, and improving financial performance. The position partners with operational, clinical, compliance, finance, and executive leaders to develop and implement revenue cycle strategies that support organizational growth, operational excellence, and financial sustainability across multiple states. It oversees internal revenue cycle activities and external vendors, evaluates performance, and leads policies, procedures, and process improvements. The role also supports growth initiatives such as new clinic locations, service-line expansions, acquisitions, and revenue cycle integrations. Familiarity with 340B program operations, compliance, pharmacy billing, and revenue optimization is strongly preferred.

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, identify operational challenges, and implement strategic solutions.
Strong leadership, change management, and team development capabilities.
Excellent written, verbal, and presentation communication skills.
Ability to build effective relationships with executive leadership, clinical leaders, finance teams, vendors, and payers.
Strong project management, problem-solving, and organizational skills, with the 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 Drug Pricing Program operations, compliance requirements, pharmacy billing, and financial implications.
Professional certifications such as HFMA, CRCR, CHFP, or similar credentials; preferred but not required.

Responsibilities

Provide strategic leadership and oversight for patient registration, charge capture, coding, billing, collections, denials management, appeals, reimbursement, and accounts receivable.
Serve as the organization’s subject matter expert on FQHC reimbursement, including Medicare and Medicaid PPS, encounter billing, and wrap payment processes.
Monitor federal and state regulatory changes affecting FQHC reimbursement and implement operational and billing improvements.
Develop and execute strategies to improve cash flow, reduce denials, increase clean claim rates, and optimize reimbursement.
Lead 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 that affect FQHC operations.
Manage governmental and commercial payer relationships to resolve reimbursement issues, negotiate operational improvements, 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.