Senior Manager, Revenue Cycle - Operational Effectiveness
Leads RCM operational effectiveness by building reporting infrastructure, managing cross-functional initiatives, and driving process improvements across billing, analytics, and governance. Requires 7+ years in healthcare revenue cycle or analytics leadership.
Responsibilities
Reporting & Analytics Infrastructure / Monthly Billing of Direct Invoice Customers
- Build and own the RCM reporting infrastructure — establishing reliable data extraction from Athena Health, Zuora, and NetSuite to support management decision-making
- Ensure the accuracy, completeness, and timely delivery of monthly client invoicing
- Develop and maintain the KPI dashboard covering AR aging, DSO, denial rates, clean claim rates, billing trigger capture rate, cash collection rates, and other key metrics defined in the KPI Framework
- Produce weekly, monthly, and ad hoc reporting for RCM leadership, Finance, and Virta executive leadership — translating operational metrics into clear financial implications
- Establish the data extraction protocol and SLA for responding to client billing inquiries — ensuring employer groups and health plans can receive timely, accurate claim-level detail
- Partner with Engineering to build automated reporting solutions that reduce manual data extraction and improve reporting accuracy and timeliness
Special Projects & Strategic Initiatives
- Lead or project-manage high-priority RCM initiatives that span multiple functional areas — including the Zuora-to-Athena reconciliation build, the Athena data access project, and the evaluation of Candid as a potential claims system replacement
- Serve as the RCM organization's point of contact for cross-functional projects involving Engineering, Finance, Strategic Finance, Legal, and Client Success
- Manage the design and implementation of the employer guarantee of payment enforcement workflow — from trigger identification through secondary invoicing and cash application
- Support the development and execution of Phase 1 SOW deliverables, including the Revenue Leakage Quantification Model (D2), Prioritized Execution Roadmap (D3), and KPI Framework (D4)
Operational Governance & Process Improvement
- Own the RCM team's issue log, ensuring all identified problems are documented, assigned, tracked, and resolved with defined SLAs
- Facilitate the weekly RCM leadership meeting — setting the agenda, tracking action items, and ensuring accountability across the team
- Lead the development and maintenance of the RCM SOP library — documenting workflows, escalation paths, and operating standards for all RCM functions
- Identify process improvement opportunities across the revenue cycle and lead structured improvement initiatives using data to validate impact
- Monitor compliance with payer contracts, timely filing requirements, and HIPAA/billing regulations — escalating risks to the Head of Revenue Cycle Management and Compliance as appropriate
Onboarding & Team Development Support
- Execute on the development of the team operating structure and onboarding plan — adhering to onboarding timelines, and training programs for the new RCM hires
- Design onboarding programs that pair new hires with documented SOPs — ensuring staff are trained to documented processes rather than absorbing current-state practices
- Track team build-out progress and report hiring and onboarding status to the Head of Revenue Cycle Management weekly
Strategic Operational Support
- Prepare briefing materials, presentations, and executive updates in collaboration with the Head of Revenue Cycle Management — including the weekly leadership deck, board-ready summaries, and ad hoc stakeholder communications
- Manage the Head of Revenue Cycle Management's strategic agenda — ensuring priority initiatives are resourced, tracked, and moving forward
- Serve as a communication bridge between the RCM team and other departments — translating RCM findings and needs into language that resonates with Finance, Legal, Engineering, and executive leadership
- Represent the RCM organization in cross-functional working groups and project teams as directed by the Head of Revenue Cycle Management
90 Day Plan
- KPI dashboard live: Operational within 60 days of hire, updated weekly
- Athena data extraction protocol: Defined and operational within 30 days of hire
- SOP library completion: Core workflows documented within Phase 2; complete library by Phase 3
- Issue log currency: 100% of identified issues logged, assigned, and tracked with resolution SLA
- Client billing inquiry SLA: Defined response process with SLA established within 60 days
- Onboarding plan (D5): Delivered within Phase 1 timeline per SOW requirements
- Weekly reporting cadence: On-time, accurate weekly reporting to RCM leadership and Finance
Must-Haves
- 7+ years of experience in healthcare revenue cycle management, healthcare analytics, or a chief of staff / operational leadership role within a healthcare organization
- Strong analytical and data skills — ability to extract, synthesize, and present complex revenue cycle data clearly for both operational and executive audiences
- Demonstrated project management experience leading cross-functional healthcare initiatives from design through implementation
- Working knowledge of revenue cycle operations — sufficient to understand the impact of billing, eligibility, AR, and denial management processes on financial performance
- Exceptional written and verbal communication skills — comfortable presenting to senior leadership and influencing without direct authority
- Proficiency with data tools — Excel/Google Sheets at an advanced level; experience with BI tools, SQL, or reporting platforms preferred
- Demonstrates a proactive use of AI tools to improve individual output and efficiency
Values-driven culture
- Put people first and take care of yourself, your peers, and our patients equally
- Have a strong sense of ownership and take initiative while empowering others to do the same
- Prioritize positive impact over busy work
- Have no ego and understand that everyone has something to bring to the table regardless of experience
- Appreciate transparency and promote trust and empowerment through open access of information
- Are evidence-based and prioritize data and science over seniority or dogma
- Take risks and rapidly iterate
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