Revenue Cycle Manager

WAYNE MEMORIAL COMMUNITY HEALTH CENTERS•Honesdale, PA

7d•Onsite

About The Position

The Revenue Cycle Manager provides strategic and operational oversight of the full revenue cycle for a Federally Qualified Health Center (FQHC) with substantial value-based reimbursement arrangements. The role is responsible for accurate charging, timely billing, cash collections, denial management, and revenue integrity across service lines, while ensuring compliance with Medicaid, Medicare, PPS, grant, and payer requirements. The Manager leads the business and revenue cycle teams and oversees front-end registration and eligibility as well as back-end coding, billing, collections, and denials. The Manager develops revenue cycle strategies that support value-based contracts, alternative payment models, and FQHC reimbursement methodologies. The role works closely with Finance, Contracting, Clinical Operations, Quality, Compliance, and Audit teams to align performance with organizational financial goals, quality measures, regulatory requirements, and value-based care objectives. The Manager reports to the Chief Financial Officer and provides regular updates on revenue cycle performance, risks, trends, and improvement opportunities. The position also oversees payer relationships and contracts, provider enrollment, revenue cycle technology, and process improvement. It directly manages the Business Office and revenue cycle teams, supporting staff development, accountability, collaboration, and ongoing operational improvement.

Requirements

Bachelor’s degree in Healthcare Administration, Finance, Business, or a related field.
At least 7 years of progressive experience in healthcare revenue cycle management.
Demonstrated experience supporting FQHC operations and reimbursement, including Medicaid and Medicare.
Strong understanding of value-based payment models, alternative payment arrangements, and revenue recognition.
Proven leadership experience managing business office and revenue cycle teams.
Knowledge of applicable federal, state, and local laws.
Keep current with trends and developments related to essential job competencies.
Commitment to and demonstration of excellent internal and external customer service.
Attention to detail and ability to lead and follow processes and procedures from beginning to end.
Interpersonal, relationship-building, and project management skills.
Strong organizational skills and ability to balance priorities and contribute as a team player.
Ability to use data and promptly inform others in the decision-making process.
Computer skills and ability to learn and operate software programs.

Nice To Haves

Certified Revenue Cycle Professional (CRCP).
Strategic and analytical thinking.
Strong financial and operational acumen.
Collaborative leadership and communication.
Regulatory and compliance awareness.
Change management and process improvement experience.

Responsibilities

Provide strategic leadership for charge capture, billing, accounts receivable, cash posting, denial management, and revenue integrity.
Develop and execute revenue cycle strategies supporting value-based contracts, alternative payment models, and FQHC reimbursement methodologies.
Report revenue cycle performance, risks, trends, and improvement opportunities to the Chief Financial Officer.
Partner with Finance and Contracting to ensure accurate revenue recognition and performance tracking for value-based, capitated, and incentive-based contracts.
Collaborate with Quality and Clinical Leadership to align revenue cycle processes with quality metrics, risk adjustment, and performance measures.
Monitor payer performance and reimbursement trends to identify opportunities for optimization and financial sustainability.
Oversee charge capture and ensure completeness, accuracy, and compliance with FQHC billing rules and payer requirements.
Ensure timely and accurate claims submission to Medicaid, Medicare, managed care, commercial, and other payers.
Manage accounts receivable performance, including aging, follow-up workflows, and resolution of complex balances.
Establish and oversee denial management focused on prevention, root-cause analysis, and recovery.
Monitor cash collections, payment posting accuracy, and reconciliation to maximize net revenue and cash flow.
Implement performance benchmarks and accountability measures to improve cash performance.
Lead revenue integrity initiatives for compliant charging, coding alignment, and documentation support.
Work with Compliance and Audit teams on regulatory requirements, audit findings, and payer inquiries.
Ensure adherence to FQHC, CMS, state Medicaid, and payer-specific billing regulations.
Directly manage Business Office and revenue cycle teams, including coaching, performance management, and professional development.
Evaluate staffing models, workflows, and technology for scalability and efficiency.
Oversee payer contracts and relationships, including enrollment for new providers.
Analyze procedures, identify inefficiencies, and implement workflow and collections improvements.
Utilize and manage billing software, EMR/EHR systems, and revenue cycle management tools.