Vice President, Revenue Cycle Management

SightMD•Town of Islip, NY

6h•$190,000 - $220,000•Hybrid

About The Position

A career that changes lives. SightMD is a rapidly growing integrated ophthalmic provider group, extending the reach of exceptional eye care to patients across New York, New Jersey, Pennsylvania, Connecticut, and Massachusetts. With over 127 eye care providers and the convenience of 60 locations, our commitment to delivering unparalleled services is at the heart of everything we do. As we embark on our mission, we are actively seeking teammates who are eager to contribute to our legacy of eye excellence, a tradition that spans more than 50 years. Position Summary: The Vice President of Revenue Cycle Management (VP, RCM) is responsible for the organization’s end-to-end revenue cycle performance, including maximizing collections, reducing revenue leakage, improving A/R, and ensuring accurate and timely reimbursement across clinical, surgical, optical, and cash-pay services. Reporting to the Chief Financial Officer, the VP oversees revenue cycle operations, payer and provider credentialing, revenue integrity, and payer strategy. This role is responsible for improving performance across the platform, standardizing processes, reducing aged A/R, and successfully integrating acquired and new practices.

Requirements

Bachelor’s degree in Finance, Accounting, Healthcare Administration, Business, or related field.
10+ years of progressive revenue cycle experience, including 5+ years in a senior/executive leadership role.
Experience leading RCM for a multi-site physician group or health system with $150M+ in annual net patient service revenue.
Demonstrated success improving A/R, collections, denials, reimbursement, and other key RCM metrics.
Strong knowledge of professional billing, payer reimbursement, CPT/HCPCS/ICD-10 coding, revenue integrity, and government and commercial payer requirements.
Experience with payer/provider credentialing and enrollment, payer contracting, and negotiations.
Experience leading RCM integration for acquisitions and PM/EHR conversions.
Experience managing large teams and outsourced/offshore RCM partners.
Strong analytical, financial, communication, and executive presentation skills.
Ability to work in a hybrid role with regular onsite presence in Hauppauge, NY.

Nice To Haves

MBA, MHA, or equivalent advanced degree.
Ophthalmology, ASC, or surgical subspecialty revenue cycle experience.
Experience with buy-and-bill pharmaceuticals and optical/vision plan revenue.
Experience in a private equity-backed MSO or physician platform.
Multi-state experience, preferably NY, NJ, PA, MA or CT.
Experience with ophthalmology PM/EHR, ASC billing, credentialing, and contract management systems.
Relevant revenue cycle, coding, or ophthalmology certification.

Responsibilities

Lead end-to-end RCM operations across all locations and entities, including patient access, eligibility, authorization, charge capture, coding, billing, collections, payment posting, denials, appeals, and A/R. Build and develop a high-performing team and establish standardized processes and performance expectations.
Drive improvements in net collection rate, days in A/R, aged A/R, cash collections, denials, underpayments, credit balances, and refunds. Establish measurable recovery plans and identify and eliminate revenue leakage.
Partner with the CFO on payer strategy and negotiations. Maintain payer performance analytics, model reimbursement and contract terms, support negotiations, and ensure contracted rates and terms are accurately implemented and enforced.
Oversee payer/provider credentialing and enrollment, including multi-state enrollment, recredentialing, revalidation, CAQH, licensing, and expirables. Lead revenue integrity, including charge capture, charge master and fee schedule governance, coding accuracy, documentation, and coding audits.
Ensure accurate billing and reimbursement for ophthalmology and ASC services, including surgical procedures, global periods, modifiers, co-management, diagnostic testing, and buy-and-bill pharmaceuticals. Oversee optical, vision plan, elective, and cash-pay revenue processes.
Lead RCM diligence and integration for acquisitions, de novo locations, and PM/EHR conversions. Own the RCM technology and automation strategy and identify opportunities to improve efficiency, reduce cost to collect, and accelerate cash.
Provide weekly and monthly RCM reporting, forecasting, payer analytics, and A/R reporting. Partner with Finance, Compliance, Legal, IT, and operational leadership to ensure regulatory compliance, financial accuracy, and effective risk management. Present performance and recommendations to executive leadership, the Board, lenders, and investors.