Senior RCM Director

Sciometrix•Royal Oak, MI

1d•Onsite

About The Position

About Sciometrix At Sciometrix, our goal is to deliver the best-ever personalized care with utmost compassion enabling patients to lead healthier and happier lives. Our commitment to innovation in healthcare technology drives us to lead the way in Care Management, Digital Care Coordination, Value-Based Care, and Population Health. We envision a world where advanced technology and human compassion intersect seamlessly to deliver superior patient experiences and outcomes. Our mission is to enhance the lives of patients by leveraging digital solutions that reduce hospital readmissions, improve health outcomes, and optimize the delivery of healthcare services. At the heart of our philosophy lies the belief that every patient deserves access to the highest quality of care, tailored to their individual needs. We strive to make this vision a reality by pioneering innovative solutions that prioritize patient well-being and provider efficiency. With Sciometrix, the future of healthcare is not just about treating illnesses; it's about empowering patients to live their best lives. What’s in It for You Make a Meaningful Impact Drive financial sustainability in healthcare by optimizing revenue cycle performance and enabling providers to deliver high-quality patient care. Cutting-Edge Telehealth Environment Work within advanced, HIPAA-compliant systems and digital health platforms that support efficient and scalable RCM operations. Collaborative, Supportive Culture Be part of a leadership team that values innovation, accountability, and cross-functional collaboration across global teams. Professional Development Gain exposure to evolving reimbursement models, value-based care strategies, and advanced RCM technologies. Competitive Compensation & Benefits Receive a competitive salary, performance-based incentives, and benefits tailored for remote professionals. Autonomy with Leadership Influence Lead large-scale RCM operations with the authority to drive strategic decisions while collaborating with executive leadership. Benefits Paid time off, Medical, Vision, and Dental Insurance, Royal Oak, MI downtown Paid Parking. Role Overview The Director – Revenue Cycle Management (RCM) is a strategic leadership role responsible for overseeing end-to-end revenue cycle operations, including payor contracting and reimbursement strategy. This role drives operational excellence, financial performance, and compliance while managing cross-functional and global teams. The ideal candidate combines deep RCM expertise with strong leadership capabilities to optimize revenue outcomes, improve operational efficiency, and align global teams with U.S. healthcare standards. Key Responsibilities RCM Leadership · Lead and manage cross-functional and global RCM teams across multiple geographies · Establish SLAs, KPIs, and governance models to ensure operational excellence · Drive productivity, quality, and turnaround time across distributed teams · Implement a follow-the-sun model for 24/7 revenue cycle efficiency · Align offshore teams with U.S. compliance, documentation, and quality standards · Manage vendor and partner relationships Revenue Cycle Operations · Oversee the complete RCM lifecycle: patient access, coding, charge capture, billing, AR, denials, and collections · Monitor and improve key performance metrics such as Days in AR, Net Collection Rate, First Pass Resolution Rate, and Denial Rate · Lead month-end revenue reporting, analytics, and forecasting Payor Contracting & Strategy · Lead end-to-end payor contracting, including negotiation, execution, and renewals · Optimize reimbursement models including fee-for-service, value-based care, capitation, and bundled payments · Manage relationships with commercial payors, Medicare, Medicaid, and MCOs · Identify revenue leakage opportunities and renegotiate contracts to maximize value · Ensure alignment between contract terms and billing practices Denial Management & Revenue Optimization · Develop and implement denial prevention strategies across global teams · Standardize root-cause analysis and corrective action frameworks · Improve clean claim rates and minimize write-offs Compliance & Risk Management · Ensure adherence to HIPAA, CMS guidelines, and U.S. healthcare regulations · Maintain audit readiness and ensure data security, including PHI protection · Oversee compliance across offshore and onshore operations Technology & Process Transformation · Optimize RCM platforms including EHR/EMR and billing systems · Drive automation, AI adoption, and workflow efficiency improvements · Collaborate with technology teams to enhance systems and processes Stakeholder Management · Partner with Finance, Clinical, Operations, and Executive Leadership teams · Provide strategic insights and reporting on revenue performance · Act as a bridge across cross-functional teams to align goals and outcomes Qualifications Education · Bachelor’s degree in Healthcare Administration, Finance, or related field · MBA or MHA preferred Experience · 12–18+ years of experience in U.S. healthcare RCM · Mandatory experience in payor contracting and negotiations · Mandatory experience managing cross-functional and global teams · Experience in telehealth, digital health, or value-based care preferred Skills · Strong leadership in distributed/global team environments · Deep understanding of RCM KPIs and benchmarking · Expertise in payor negotiations and reimbursement optimization · Strong communication and stakeholder management skills · Knowledge of HIPAA, CMS guidelines, ICD-10, CPT, and HCPCS Success Metrics (KPIs) · Reduction in Days in AR · Net Collection Rate > 95% · Denial Rate < 5% · Clean Claim Rate > 98% · Improved payor reimbursement rates and contract value · Increased productivity across the RCM function Sciometrix is an Equal Opportunity Employer and is proud to offer equal employment opportunity to everyone regardless of race, color, ancestry, religion, gender, national origin, sexual orientation, age, citizenship, disability, gender identity, veteran status, and more.

Requirements

Bachelor’s degree in Healthcare Administration, Finance, or related field
12–18+ years of experience in U.S. healthcare RCM
Mandatory experience in payor contracting and negotiations
Mandatory experience managing cross-functional and global teams
Strong leadership in distributed/global team environments
Deep understanding of RCM KPIs and benchmarking
Expertise in payor negotiations and reimbursement optimization
Strong communication and stakeholder management skills
Knowledge of HIPAA, CMS guidelines, ICD-10, CPT, and HCPCS

Nice To Haves

MBA or MHA preferred
Experience in telehealth, digital health, or value-based care preferred

Responsibilities

Lead and manage cross-functional and global RCM teams across multiple geographies
Establish SLAs, KPIs, and governance models to ensure operational excellence
Drive productivity, quality, and turnaround time across distributed teams
Implement a follow-the-sun model for 24/7 revenue cycle efficiency
Align offshore teams with U.S. compliance, documentation, and quality standards
Manage vendor and partner relationships
Oversee the complete RCM lifecycle: patient access, coding, charge capture, billing, AR, denials, and collections
Monitor and improve key performance metrics such as Days in AR, Net Collection Rate, First Pass Resolution Rate, and Denial Rate
Lead month-end revenue reporting, analytics, and forecasting
Lead end-to-end payor contracting, including negotiation, execution, and renewals
Optimize reimbursement models including fee-for-service, value-based care, capitation, and bundled payments
Manage relationships with commercial payors, Medicare, Medicaid, and MCOs
Identify revenue leakage opportunities and renegotiate contracts to maximize value
Ensure alignment between contract terms and billing practices
Develop and implement denial prevention strategies across global teams
Standardize root-cause analysis and corrective action frameworks
Improve clean claim rates and minimize write-offs
Ensure adherence to HIPAA, CMS guidelines, and U.S. healthcare regulations
Maintain audit readiness and ensure data security, including PHI protection
Oversee compliance across offshore and onshore operations
Optimize RCM platforms including EHR/EMR and billing systems
Drive automation, AI adoption, and workflow efficiency improvements
Collaborate with technology teams to enhance systems and processes
Partner with Finance, Clinical, Operations, and Executive Leadership teams
Provide strategic insights and reporting on revenue performance
Act as a bridge across cross-functional teams to align goals and outcomes