# Senior Revenue Cycle Strategy and Operations Manager

**Company:** [Pomelo Care](https://hotfix.jobs/companies/pomelo-care)
**Location:** Remote
**Role:** Revenue Operations
**Salary:** $135k – $150k/yr
**Experience:** 5+ years
**Skills:** Revenue Cycle Management, Healthcare Billing, Medicaid Billing, Medical Coding, Denial Management, Google Sheets, Excel, SQL, Metabase, Tableau, Looker, Ehrs, Clearinghouses, Financial Modeling, Data Analytics
**Posted:** 2026-08-28

> Leads pricing, billing architecture, client onboarding, technology optimization, analytics, and denial strategy for healthcare revenue cycle operations. Requires 5+ years of healthcare RCM experience, strong billing and coding expertise, advanced spreadsheet skills, and cross-functional project leadership.

## Job Description

## Responsibilities
- Partner with Finance to design, evaluate, and implement competitive pricing strategies.
- Lead coding discussions and develop hybrid fee-for-service and per-member-per-month billing models that optimize commercial agreements and customer lifetime value.
- Lead revenue cycle management (RCM) onboarding for new B2B clients and complex lines of business.
- Map, document, and implement billing workflows across Sales, Customer Success, and Product.
- Own high-level operational escalations and streamline resolution processes.
- Partner with the technology team to build, refine, and manage the proprietary RCM technology stack.
- Ensure integrations support scalable operations, audit readiness, data quality, and transaction-cost control.
- Serve as the strategic super-user across EHRs, clearinghouses, and internal databases.
- Research healthcare industry shifts, plan benefit changes, and regulatory updates; adapt systems proactively.
- Analyze the financial impact of payer rules and benefit structures and communicate findings to leadership.
- Monitor revenue-cycle health and performance metrics using Metabase or similar BI tools; identify systemic denial trends.
- Build and maintain financial models to audit billing data, reconcile payments, and track implementation milestones.
- Establish quality metrics, audit guidelines, and standard operating procedures for billing workflows.
- Own denial-management strategy, identify root causes, and prevent future claim rejections.
- Monitor and optimize claim submission, clearinghouse error resolution, payment posting, and other core RCM processes.

## Requirements
- 5–7 years of healthcare revenue cycle experience, ideally in a healthcare startup, digital health company, or multi-specialty group.
- Experience partnering with Finance on pricing structures and with Product or Technology on scalable operational tools.
- Deep knowledge of commercial and Medicaid insurance billing, claim formats, and denial resolution.
- Advanced proficiency in Google Sheets and Microsoft Excel.
- Experience managing high-impact projects, implementing software configurations, and building cross-departmental consensus as a senior individual contributor.
- Ability to operate strategically in ambiguous environments and design scalable operational processes.

## Nice to Have
- Experience with coding discussions and emerging healthcare benefits, such as doula care or value-based capitation models.
- Basic SQL skills.
- Experience with Metabase, Tableau, or Looker.
- Experience leveraging AI to improve work-product efficiency and effectiveness.

## Compensation and Benefits
- Base salary: $135,000–$150,000 annually.
- Eligible for an annual discretionary bonus and equity participation.
- Medical, dental, and vision coverage for employees and families.
- High-deductible health plans with HSA options.
- Flexible Spending Account.
- 401(k) program.
- Competitive vacation policy.
- 16 weeks of paid parental leave.
- Fully remote work flexibility within the United States.

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