Manager, Revenue Cycle Management

Daymark Health

10h•Remote

About The Position

Daymark Health is seeking a highly capable operator to build and lead Revenue Cycle Management at Daymark. This is a foundational role as we expand our primary care service lines. You will own the end-to-end revenue cycle function, including professional billing, third-party billing vendor management, claims operations, and risk adjustment, while partnering closely with Clinical Operations, Finance, Product, and Data. The right candidate brings deep technical fluency in PCP-focused billing codes, hands-on experience managing billing vendors and clearinghouse platforms, and a forward-thinking orientation toward AI-enabled RCM. This role is ideal for someone who wants to build a function from the ground up and grow with it.

Requirements

Deep knowledge of PCP revenue cycle, including fluency with E&M, AWV, CCM, TCM, APCM, and PCM billing rules, documentation requirements, and reimbursement structures
Direct experience managing a third-party billing vendor and a claims/clearinghouse platform
Experience with HCC coding, risk adjustment suspecting, and chart review workflows
Familiarity with AI applications in RCM and a genuine interest in applying them
You are both strategic and highly execution-oriented; you can design the system and work within it
You bring strong analytical instincts and are comfortable working with billing data directly
You can partner effectively across clinical, operational, finance, and technical teams
You are energized by building from scratch
You have high standards for compliance and billing integrity

Nice To Haves

Experience at a startup or high-growth healthcare company is a plus

Responsibilities

Own Daymark's Revenue Cycle Operations
Lead end-to-end RCM across all payer types, with primary focus on Original Medicare and value-based contract populations
Develop and maintain billing protocols for PCP service lines including E&M, Annual Wellness Visits (AWVs), Chronic Care Management (CCM), Transitional Care Management (TCM), and Advanced Primary Care Management (APCM)
Establish patient billing workflows including statement generation, cost-sharing communication, and collections processes; ensure workflows are sensitive to the patient experience while maintaining collection integrity
Manage the third-party billing vendor relationship, including performance monitoring, issue escalation, contract compliance, and ongoing optimization
Own the claims and clearinghouse platform, including submission workflows, rejection and denial management, and resubmission processes
Establish and track RCM KPIs: clean claim rate, denial rate, days in AR, net collection rate, and others
Partner with Finance on revenue recognition, cash flow forecasting, and month-end close support
Support accurate risk adjustment operations aligned with our care model and payer contracts
Partner with Clinical Operations, Product and Data to ensure risk adjustment workflows are reflected in tooling and supported from pre-chart prep to documentation and through billing and claim submission
Support end-to-end enrollment workflows for new providers, including NPI registration, CAQH profile maintenance, and payer-specific credentialing applications
Track credentialing status and expiration timelines across the provider panel to ensure no gaps in billing eligibility
Partner with Clinical Operations and People to build onboarding workflows that sequence credentialing milestones with provider start dates
Identify and manage credentialing vendors or delegated credentialing arrangements where applicable
Identify and evaluate AI-enabled tools across the RCM workflow, including automated coding assistance, denial prediction, and other capabilities
Partner with Product and Data to pilot and implement capabilities that improve throughput and accuracy
Translate billing and compliance requirements into scalable operational workflows
Establish audit and QA processes to ensure coding accuracy and billing integrity
Identify execution gaps and drive resolution across cross-functional teams