Sr. Director, RCM

Daybreak Health

3h • Remote

About The Position

Daybreak Health delivers teletherapy to young people and families through schools, funded by health plans. The Senior Director of Revenue Cycle Management owns the revenue cycle end to end, from enrollment through cash, for Medicaid and managed care organizations (MCOs), outpatient behavioral health, telehealth, and clinicians licensed across multiple states. This is a build role focused on closing operational gaps through process improvement and automation rather than increasing headcount in proportion to claim volume.

The Senior Director reports to the President and Co-Founder and leads an RCM team consisting of an RCM Manager, a Lead Billing Specialist, and Billing Specialists. The role partners closely with Finance, Clinical Operations, Product and Engineering, and Credentialing, presents directly to executives, and is accountable for the cash generated by the function.

The leader will improve AR and denials by identifying root causes; establish reliable performance metrics and reporting; own EHR, clearinghouse, and billing platform relationships and configuration; strengthen front-end revenue integrity; deploy automation and AI with appropriate controls; support Finance with cash forecasting, close, accruals, reserves, and AR allowance; and maintain compliance around confidentiality, minor consent, HIPAA, and payer audits. Success includes trusted and improving collections metrics, reducing aged AR and denials, scaling RCM capacity more slowly than claim volume, reliable financial inputs, effective cross-functional workflows, and documented and followed confidentiality and audit-readiness practices.

Requirements

• 10+ years of experience in revenue cycle management, including 5+ years leading RCM teams.
• Experience in one or two startups, including building from square one and adapting as the business changes.
• Deep expertise in outpatient behavioral health and Medicaid/MCO billing.
• Practical, hands-on use of AI and automation to improve work, with good judgment about where human review remains necessary.
• Track record of establishing reporting, automating manual work, and leading system migrations.
• Comfort owning numbers publicly and explaining when forecasts miss.
• Strong executive communication, including the ability to turn complex billing findings into clear recommendations with tradeoffs.
• Ability to influence stakeholders and drive change without direct authority, especially across Clinical Operations, Product, and Engineering.

Nice To Haves

• Experience with school-based, pediatric, or youth behavioral health programs.
• Experience billing across multiple states with a multi-state licensed clinician workforce.
• Familiarity with BI tools.
• Exposure to value-based or outcomes-linked payer contracts.

Responsibilities

• Own the revenue cycle end to end, from enrollment through cash.
• Lead the RCM team, which includes an RCM Manager, a Lead Billing Specialist, and Billing Specialists.
• Analyze aging reports, identify where revenue is stuck, and address root causes of denials and slow payments.
• Track and report net collection rate, days in AR, clean claim rate, denial rate, and cost to collect using reliable definitions and reporting.
• Own EHR, clearinghouse, and billing platform relationships and configuration; address process gaps and collaborate with Engineering on product-level solutions.
• Own real-time eligibility and benefits verification at intake, patient responsibility, and estimates; influence Clinical Operations workflows and drive upstream behavior change.
• Identify and implement automation and AI for manual billing, posting, follow-up, and reconciliation, with appropriate controls and human review.
• Partner with Finance on close, accruals, reserves, AR allowance, and cash forecasting, providing timely numbers, assumptions, and variance explanations.
• Establish operating practices to manage confidentiality risks in EOBs and statements, minor-consent handling, HIPAA, and payer audit exposure.
• Present directly to executives and communicate billing findings and recommendations, including tradeoffs.
• Work across Clinical Operations, Product, Engineering, Finance, and Credentialing to align workflows and revenue-cycle practices.

Benefits

• Generous equity package.
• Medical, dental, and vision coverage, with Daybreak covering a significant share of premiums for employees and dependents.
• Flexible unlimited time off.
• Company holidays.
• Quarterly mental health days.
• Fully remote work from anywhere in the United States.

What This Job Offers

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