Revenue Cycle Management / RCM Lead (Director Level)

Candid Health

11d • $150,000 - $185,000 • Hybrid

About The Position

The Revenue Cycle Management (RCM) Lead is a senior leader responsible for overseeing the full spectrum of revenue cycle operations across Candid Health's portfolio of clients. This role drives enterprise-wide financial performance, and operational excellence in billing, denial management & prevention, reconciliation, and payer relations. This senior leader is responsible for day-to-day management of the Candid RCM team, including being hands-on alongside billers. This person will also own cross-functional initiatives to optimize revenue cycle workflows, enhance data transparency, and support scalable growth aligned with Candid Health’s evolving business needs. This role will also represent Candid Health externally with customers, partners, payers, and internally as a mentor and leader of high-performing teams.

Requirements

• You have 8-12+ years of medical billing experience, including at least 2-3 years of experience building and leading large, high-performing teams to deliver key business outcomes in complex, dynamic environments.
• You have a strong track record of driving revenue outcomes & efficiencies for RCM functions
• You have strong analytical skills - you have a learning and investigative mindset and value those mindsets in others.
• You are capable of rolling up your sleeves at an operational and tactical level to drive results alongside your team.
• You approach RCM preventatively vs reactively - you have a mindset of using technology to prevent denials/rejections upstream.
• You have a wide range of experience across multiple specialties, multi-state billing, and telehealth billing.
• You have experience across a wide range of the revenue cycle: EDI Enrollments, Payment Posting and Reconciliation, Denial Resolution and Management, etc.
• You are a clear and concise communicator; you enjoy the challenge of explaining complicated ideas in simple terms, both in-person and in writing.
• You are motivated by and have a track record of building and maintaining relationships with senior executive customer stakeholders.
• Experience collaborating with product/engineering teams, go to market teams, customer execution and delivery teams.

Nice To Haves

• Experience managing both onshore and offshore teams is preferred

Responsibilities

• Hire, manage and lead high-performing onshore and offshore teams, responsible for delivering strong revenue cycle operations within billing, EDI, denial management, and payment posting for Candid’s portfolio of customers.
• Drive RCM KPIs and outcomes by getting into the details on specific claim-level and claim cohort level issues alongside Billers and Billing Leads (This position has a high degree of operational and tactical execution).
• Build & scale the department by creating and refining playbooks, standardized processes, and data management frameworks.
• Oversee customer portfolios by dynamically adjusting resourcing and priorities to ensure high-quality service delivery.
• Monitor key metrics to adjust resourcing and priorities, ensuring capacity aligns with fluctuating demand and new customer onboarding.
• Act as the primary point of contact for complex customer issues, providing expert consultation and decisive resolutions to maintain client trust in partnership with our Customer Strategy & Operations team.
• Partner closely with Customer Support and Customer Strategy & Operations teams to identify systemic customer issues and implement proactive long-term solutions.
• Set strategic direction on scaling the scope of operations for the growing RCM team.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: No Education Listed