Finance Manager

Serene Health•San Diego, CA

14h

About The Position

Optima Medical Management Group, including its divisions Serene Health, Community Support, and American TrueCare, is dedicated to enhancing the quality of life by promoting wellness and providing comprehensive support and care. The company aims to lead in member care outcomes, set new standards for excellence and innovation, and empower members towards self-sufficiency in health. Optima MMG fosters a work culture built on pride, passion, and collaboration, encouraging continuous learning and professional growth. A career here offers the opportunity to be part of a dynamic organization transforming lives and communities. The Finance Manager, officially titled Revenue Cycle Manager, is responsible for overseeing and optimizing all billing and reimbursement functions across Serene Health Group. This role manages both capitated and fee-for-service (FFS) revenue streams, ensuring accurate payment, reconciliation, and financial performance across Medi-Cal and Managed Care contracts. The Finance Manager partners closely with operations, finance, and leadership to identify revenue gaps, resolve discrepancies, and ensure compliant, efficient revenue cycle operations.

Requirements

Bachelor’s degree in Healthcare Administration, Finance, or related field required.
Minimum of 5 years of revenue cycle management experience.
Experience with capitated payment models and fee-for-service billing.
Experience with Medi-Cal and Managed Care billing.
Experience with clearinghouses such as Waystar.
Strong proficiency in Excel and reporting/analytics.
Strong analytical and problem-solving skills.
Excellent written and verbal communication skills.
High attention to detail and organizational skills.
Ability to manage multiple priorities and meet deadlines.
Ability to interpret payer contracts and reimbursement structures.
Proficiency in billing systems, clearinghouses, and Microsoft Office (Excel, Word).
Ability to work in a fast-paced, growth-oriented environment.

Responsibilities

Oversee day-to-day revenue cycle operations, including claims submission, payment posting, denials management, and accounts receivable (AR).
Ensure timely and accurate billing and reimbursement across Medi-Cal and Managed Care payer contracts.
Manage and reconcile capitated revenue streams, including member rosters, payment tracking, and variance analysis.
Oversee fee-for-service billing, including claims accuracy, submission, and reimbursement optimization.
Identify and resolve discrepancies between expected and actual payments across all payer arrangements.
Monitor AR performance and ensure timely follow-up on outstanding claims.
Analyze denial trends and implement corrective actions to improve reimbursement outcomes.
Ensure compliance with CMS, Medi-Cal, DHCS, and payer-specific billing requirements.
Support internal and external audits and maintain documentation to minimize recoupment risk.
Develop and maintain reporting dashboards related to AR, payments, denials, and revenue trends.
Utilize reporting tools to analyze financial performance and provide actionable insights.
Partner with operations and leadership to ensure alignment between services rendered and revenue captured.
Perform other duties as assigned.

Benefits

Medical, Dental, & Vision Benefits: We have various insurance options for you and your family.
Short & Long-Term Disability Benefits: Protection when you need it most.
Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.
Flexible Spending Accounts: Manage your finances with flexibility.
Employee Assistance Program (EAP): Support when life throws challenges your way.
401(K): Building your financial future with us. Effective after 1 year of employment.
Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.
Paid Holidays: Quality time to enjoy celebrations.
Employee Referral Program: Share the opportunities and reap the rewards.
Company Discount Program: Enjoy savings on everyday expenses and memberships.