Senior Director RCM

VAXCARE LLC • Orlando, FL

2h • Hybrid

About The Position

The Senior Director of Revenue Cycle Management (RCM) will lead backend revenue cycle operations for a national vaccine administration organization operating across 44 states. This role is heavily focused on denial management, accounts receivable optimization, and scalable workflow design in a high-volume environment processing over 5 million claims annually. The ideal candidate brings deep expertise in denial management operations, clearinghouse workflows, and the broader RCM technology ecosystem, coupled with a strong track record of driving process improvement and automation. This role will also require a working understanding of how billing platforms integrate with multiple partner EHR systems to support a distributed care delivery model.

Requirements

• Bachelor’s degree in healthcare, business, health information management, or a related field
• 7+ years of progressive experience in Revenue Cycle Management, including leadership roles
• Demonstrated success managing operations in a high-volume environment
• Deep understanding of: Medicare, Medicaid, and commercial payer billing, Denial management and AR optimization, End-to-end RCM workflows
• Strong experience with RCM technology platforms, including: EHR systems, Clearinghouses, Revenue cycle analytics and reporting tools
• Proven ability to lead operational transformation and implement scalable process improvements
• Dependability – Must be able to meet deadlines, work independently, maintain focus, & punctual
• Interpersonal Skills – Builds strong relationships & contributes to a positive work environment.
• Computer Skills – Skilled with computers, learns new tools quickly.
• Ethics – Honest, accountable, maintains confidentiality.

Nice To Haves

• Master's degree preferred
• Experience in vaccine administration, outpatient services, or high-throughput preventive care models
• RCM Consulting experience with exposure to multi-client or multi-state environments
• Experience managing multi-state regulatory complexity

Responsibilities

• Lead day-to-day operations across the full revenue cycle, including: Patient registration and eligibility, Charge capture and coding, Claims submission and clearinghouse management, Payment posting, AR follow-up, and denial management
• Manage throughput and performance in a high-volume claims environment with a focus on accuracy, timeliness, and scalability
• Establish and monitor KPIs (e.g., clean claim rate, days in AR, denial rate, net collection rate)
• Serve as a strategic leader in RCM technology and systems, including EHRs, practice management systems, and clearinghouses
• Partner with IT and vendors to: Design and optimize charge routing, payer logic, and claim edits, Implement automation, AI, and workflow tools to improve efficiency, Lead system upgrades, integrations, and process redesign initiatives
• Drive enterprise denial management strategy: Root cause analysis and remediation, Payer-specific workflow optimization
• Partner with payer contracting and compliance teams to ensure alignment with: Vaccine billing requirements (including CMS, state Medicaid variations, and commercial payer policies), Timely filing and documentation standards
• Ensure adherence to federal and state billing regulations across 44 states
• Maintain audit-ready processes for CMS, Medicaid, and commercial payer requirements
• Oversee compliance related to vaccine administration billing, including counseling, preventive services, and modifier usage
• Lead and develop high-performing RCM teams (onshore/offshore as applicable)
• Establish accountability through clear performance expectations and regular reporting cadence
• Drive continuous improvement culture focused on scalability and quality
• Partner with clinical operations, finance, IT, and external vendors to align revenue cycle strategy with organizational growth
• Support executive leadership with reporting, forecasting, and decision support related to revenue performance

Benefits

• Commute to Office (if applicable): Must be able to commute to and from the corporate office for each scheduled shift.
• Prolonged sitting or standing: Team members must be able to remain in a stationary position for extended periods, as the majority of work involves sitting or standing at a computer or workstation.
• Repetitive motions: Significant use of the hands, wrists, and fingers is required for tasks like typing, using a computer mouse, and handling paperwork.
• Visual acuity: This job requires the ability to view a computer screen and read documents for extended periods.
• Communication: Team members must be able to clearly express and exchange ideas in English to effectively communicate with customers and co-workers.
• Occasional lifting: Many office-based jobs specify the ability to occasionally lift or move up to 10–20 pounds to handle supplies or equipment.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior