Manager, Revenue Cycle Management
About The Position
Daymark Health is seeking a highly capable operator to build and lead Revenue Cycle Management at Daymark. This role 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 ideal candidate will have deep technical fluency in billing and claims processing, hands-on experience managing billing vendors and clearinghouse platforms, and a forward-thinking orientation toward AI-enabled RCM. This is an opportunity for someone who wants to build a function from the ground up and grow with it.
Requirements
- 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
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
