RCM Director

Stella Mental Health•Chicago, IL

About The Position

The RCM Director is responsible for the performance of Credentialing, Access, and Billing (RCM), three core functions that enable patient access and drive revenue and cash outcomes. This leader understands the interdependence of these areas and ensures they operate as a cohesive system. They bring a hands-on, solutions-oriented approach to improving workflows, strengthening payor relationships, and delivering consistent, measurable results.

Requirements

Bachelor’s degree in Healthcare Administration, Business, or related field
7+ years of leadership experience across credentialing, access (VOB/PA), and/or revenue cycle management
Deep understanding of multi-state payor environments, including Medicare, Medicaid, and commercial plans
Proven experience in payor contracting and rate negotiation
Strong command of end-to-end revenue cycle performance and cash drivers
Experience with EMR and RCM platforms (Athena preferred) and automation/AI tools
Demonstrated ability to build systems, lead teams, and drive measurable financial and operational outcomes

Responsibilities

Build and lead a fully integrated operating model across Credentialing, Access, and Billing
Ensure providers are enrolled, contracted, and billable as efficiently as possible
Drive consistent, high-quality VOB and prior authorization performance across all markets
Improve cash collections, predictability, and revenue cycle performance
Strengthen payor relationships and contracting position across geographies
Implement scalable SOPs, workflows, and technology (including AI tools)
Coordinate with Market Leaders to educate field personnel on their impact on RCM efficiency
Lead and operate the credentialing and payor engagement function with a focus on accuracy, speed, and strong external relationships.
Oversee the full credentialing lifecycle, including enrollments, re-enrollments, re-attestations, monitoring, and maintenance
Ensure data integrity, documentation, and record keeping across all credentialing activities
Leverage platforms (e.g., Assured) to drive efficiency, visibility, and compliance
Maintain a clear understanding of entity structure and its impact on enrollment, billing, and reimbursement
Build and manage strong relationships with payor representatives, serving as a primary point of contact and escalation
Lead payor contracting efforts, including: Individual, group, and national agreements, Rate negotiations and reimbursement optimization, Multi-state contracting strategies
Identify and resolve barriers to ensure providers are live and billable without delay
Own the processes that enable patients to access care efficiently, with clear expectations and minimal administrative friction.
Drive consistent production and quality of VOB and prior authorizations across all markets and modalities
Establish and enforce standard operating procedures, workflows, and performance standards
Ensure collection of full patient financial responsibility at time of service (TOS) across all markets, establishing consistent pre-service financial clearance workflows
Monitor performance to ensure timely approvals and minimal delays to treatment
Build structured processes to challenge and overturn denials, including peer-to-peer workflows
Ensure patients receive clear, accurate financial information prior to starting treatment
Support teams in removing administrative barriers that impact timely access to care
Partner with AI and automation initiatives (e.g., Nanonets) to improve throughput and consistency, enhance accuracy and efficiency, and continuously refine workflows
Provide leadership and accountability for the full revenue cycle, with a focus on performance, discipline, and cash outcomes.
Own the end-to-end revenue cycle, including charge capture, coding, claims submission, denial management, and collections
Drive team productivity and accountability across internal and external billing resources
Monitor and improve key metrics, including: Cash collections, Days in AR, Denial rates and recovery, Clean claim rates, Monitoring and pursuit of underpayments
Identify breakdowns in performance and address root causes across credentialing, access, and billing workflows
Implement billing optimization strategies, including coding accuracy and “incident-to” billing where appropriate
Oversee the use of third-party vendors and partners, ensuring performance expectations are met
Partner with Finance to ensure alignment on cash performance, forecasting, and budget expectations
Leverage AI tools and automation to improve efficiency and scalability
Align Credentialing, Access, and Billing into a single, cohesive operating model
Establish clear KPIs, reporting, and operating cadence across all functions
Serve as the internal subject matter expert and escalation point for payor, access, and RCM challenges
Partner with Clinical, Operations, and Finance teams to ensure alignment from intake through reimbursement
Build and lead teams with a focus on accountability, consistency, and continuous improvement