Senior Manager, Revenue Cycle Optimization & Strategy

InStride Health

1h•$130,000 - $145,000•Remote

About The Position

InStride Health is seeking a Senior Manager, RCM Optimization & Strategy to identify and address the root causes of denials, front-end rejections, and revenue leakage across its Revenue Cycle Management (RCM) operations. Reporting directly to the Senior Director of RCM, this high-impact senior individual-contributor role serves as a strategic bridge between core RCM workflows—including billing, cash posting, accounts receivable, and patient collections—Payor Operations, and the analytics and technology that support them. The role owns billing system setup and payor billing logic, leads root-cause analysis of denials and underpayments, and develops the KPI framework used to measure RCM performance. It does not manage the billing and AR team; instead, it equips the team and the Senior Director of RCM with insights, workflows, and system improvements. The position collaborates with RCM, Payor Operations, Licensing & Credentialing, Authorization & Eligibility, Clinical Admissions, Clinical Operations, and IT to reduce front-end errors, streamline workflows, resolve systemic payor issues, and maximize collections. As the function grows, the role may have the opportunity to develop into people leadership. This is a fully remote position.

Requirements

At least 6 years of progressive healthcare revenue cycle management experience, including at least 3 years in an analytical, optimization, or process-improvement capacity.
Bachelor’s degree in Healthcare Administration, Finance, Business Analytics, or a related field, or at least 10 years of healthcare RCM experience.
Proven ability to use complex data sets to streamline RCM operations, reduce claim denials, and recover lost revenue.
Strong project management background and demonstrated success leading cross-functional technology or process-improvement projects.
Exceptional analytical and problem-solving skills and high attention to detail.
Clear written and verbal communication skills, including the ability to translate complex revenue-cycle data into actionable insights for diverse teams.
Collaborative mindset and proven ability to build effective relationships across clinical, operational, and technical leadership.
Working knowledge of insurance payor policies, billing guidelines, and claims submission requirements.
Familiarity with CPT and ICD-10 codes and their impact on billing and reimbursement.
Hands-on experience with payor contract analysis, fee schedule audits, and underpayment identification and recovery.
Experience configuring billing platforms.

Nice To Haves

Experience with Apero, Sigma, Mahler, or similar RCM software.
Behavioral health or telehealth billing background.
Experience in a fast-paced, high-growth, or startup healthcare environment.
Hands-on experience building custom clearinghouse rules and robotic process automation (RPA) or AI solutions.
Advanced technical mastery in SQL, BI reporting platforms such as Looker or Power BI, EHR/PM systems, and clearinghouse rule builders.
Passion for pediatric mental health and expanding access to high-quality care.

Responsibilities

Analyze end-to-end RCM workflows from pre-billing through denial resolution and patient collections to remove manual processes and bottlenecks and address revenue leakage; design, test, and implement streamlined workflows with the Senior Director of RCM.
Own billing system setup and configuration across Apero, Sigma, and Mahler, including payor billing logic, fee schedules, and contract terms.
Build, maintain, and refine RCM KPI dashboards, including clean claim rate, denial rate, days in AR, claim lag, appeals, and collection rate, and share insights with the Senior Director of RCM and the team.
Audit billing engine rules, rule logic, and fee schedules to ensure ongoing compliance with payor guidelines and coding updates.
Lead root-cause analyses of claim denials and underpayments and recommend durable fixes to the Senior Director of RCM and partner teams.
Review claims escalations from the billing and AR team, confirming internal options and appeal pathways have been exhausted and escalation files are complete before issues are sent to payors.
Partner with Technology teams to implement automation for claim submission, denials management, and revenue capture.
Partner with Payor Operations to address systemic payor issues involving claim submission and resolution, including issues requiring health-plan escalation.
Manage internal and clearinghouse configuration rules to resolve pre-claim edits and front-end rejections upstream.
Coordinate with Licensing & Credentialing on downstream claims issues and with Authorization & Eligibility on eligibility-driven claim errors; partner with Patient Access and Clinical Operations to reduce intake-driven denials.
Lead change management for new billing tools, software integrations, and workflow changes, partnering with the Senior Director of RCM to train and support the team.
Deliver executive-level RCM insights, progress updates, and financial performance reporting to the Senior Director of RCM and executive leadership.