Revenue Cycle Program Manager

The Oncology Institute of Hope and Innovation•Cerritos, CA

4d•$87,546 - $124,636

About The Position

At The Oncology Institute, revenue cycle excellence isn’t just about financial performance—it’s about ensuring patients can access timely, compassionate, and cutting-edge cancer care. As a Revenue Cycle Program Manager, you play a critical role at the intersection of mission, strategy, and operational excellence. Your work directly supports patients during some of the most vulnerable moments of their lives. By optimizing reimbursement, improving access, and reducing administrative friction, you help ensure clinicians can focus on what matters most: delivering exceptional oncology care. The Revenue Cycle Program Manager leads enterprise oncology initiatives that improve professional and technical revenue cycle performance across fee‑for‑service and value‑based care models. This role oversees complex, cross‑functional programs that strengthen drug and infusion revenue integrity, reduce revenue leakage, improve cash flow, and support capitated oncology arrangements. The role requires deep oncology revenue cycle expertise and experience working with Unlimited Financials, McKesson iKnowMed, and Elekta MOSAIQ, with a strong ability to connect clinical, operational, financial, and payer teams.

Requirements

Deep understanding of oncology billing, coding, and payer dynamics
Strong knowledge of infusion and radiation therapy workflows
Familiarity with oncology value‑based payment models and pathways
Exceptional stakeholder management and provider communication skills
Strong financial and analytical acumen
Advanced Excel and PowerPoint skills
Ability to translate clinical workflows into system and revenue cycle requirements
Bachelor’s degree in Healthcare Administration, Business, Finance, or similar field
7 to 10+ years in healthcare revenue cycle, oncology operations, or consulting
Experience working in oncology physician groups or cancer networks
PMP or equivalent
HFMA certifications (CRCR, CHFP)
Lean Six Sigma Green or Black Belt

Nice To Haves

Master’s degree (MBA, MHA, MPH) preferred
Experience with BI tools (Power BI, Tableau) preferred
Oncology revenue cycle or coding experience strongly preferred

Responsibilities

Lead a portfolio of oncology revenue cycle and value‑based care initiatives from planning through execution and sustained outcomes.
Develop program charters, timelines, financial impact estimates, risk mitigation plans, and success metrics.
Establish governance structures and provide regular executive‑level reporting on progress, risks, and realized benefits.
Drive end‑to-end optimization of oncology professional and technical billing workflows, including: Scheduling, eligibility, referrals, and prior authorization for chemotherapy, procedures, and radiation services Registration accuracy and payer data integrity Charge capture and coding for E&M, infusion, injections, radiation therapy, and supportive care Drug acquisition cost alignment, waste documentation, and revenue integrity Claims submission, clearinghouse edits, and payer adjudication Denials prevention and appeals (medical necessity, authorization, drug coverage) Accounts receivable follow‑up, underpayment identification, and collections
Identify and remediate oncology‑specific revenue leakage (e.g., missed charges, incorrect modifiers, payer pathway restrictions, drug reimbursement variances).
Partner with Value‑Based Care, Clinical, and Pharmacy teams to support: Oncology‑specific value‑based arrangements Alignment of care delivery with cost, quality, and utilization targets Performance tracking for quality and utilization Support care management and supportive oncology services tied to alternative payment models.
Collaborate with Managed Care and Authorization teams to: Improve prior authorization accuracy and turnaround times Reduce authorization‑related denials and treatment delays Monitor payer adherence to oncology contract terms and reimbursement methodologies Support escalation, appeals, and underpayment recovery efforts Translate payer oncology contract terms into operational workflows and billing rules.
Prioritize and problem-solve issues, process gaps via RCA, Lean, Six Sigma or similar best practices.
Define and track KPIs across FFS and capitated oncology models, including: Clean claim rate, denial rate, and appeal overturn rate Days in AR by payer and service type (infusion, radiation, professional) Drug reimbursement variance and write‑off trends Charge and coding lag for oncology encounters Financial performance against capitated or bundled payment targets
Partner with analytics teams to develop dashboards that support practice‑level and executive decision‑making.
Lead or support revenue cycle initiatives involving: Unlimited Financials(billing, AR, reporting, reconciliation) McKesson iKnowMed(oncology EHR, charge capture, clinical documentation) Elekta MOSAIQ(radiation oncology scheduling, treatment documentation, billing integration)
Ensure accurate integration and workflow alignment across clinical, financial, and billing systems.
Translate operational needs into business requirements, UAT scenarios, training plans, and adoption strategies.
Partner with oncologists, radiation oncologists, nursing, pharmacy, and practice leadership to: Improve documentation and charge capture accuracy Reinforce authorization and pathway compliance Drive adoption of standardized workflows across sites of care
Develop SOPs, job aids, and training materials for clinical and revenue cycle teams.
Ensure oncology billing and coding practices comply with payer policies and regulatory requirements.
Partner with Compliance and Audit teams to address findings related to drug billing, medical necessity, and authorization.
Support provider education and corrective action plans to mitigate compliance and financial risk.
Live and exemplify TOI core values, providing outstanding customer service and promoting a positive experience for patients and staff members.