Provider Contracting Director
The Cigna Group
Director of Revenue Cycle
National Association of Community Health Centers (NACHC)
full-time
Posted on:
Origin: • 🇺🇸 United States • Tennessee
Visit company websiteJob Level
Lead
About the role
- Lead revenue cycle team and serve as the quarterback of RCM efforts
- Own revenue cycle playbook, identify process improvements and update training materials
- Work with operations, product, and finance teams to refine processes and policies
- Serve as a member of Diana Health’s Billing Committee to adopt and amend key policies
- Implement and maintain RCM technologies and automation tools
- Lead a team of billers and coders; monitor and manage KPIs with manager
- Facilitate cross-team learning and subject matter expertise development
- Regularly review KPIs with Analytics and Athena to identify opportunities and follow up
- Ensure end-to-end revenue cycle process effectiveness across sites
- Translate contract terms for accurate claims submission and client communication
- Oversee financial planning & Verification of Benefits (VOB) and patient payment collection
- Manage claims submissions, follow-up, payment posting, refunds, and collections
- Work with finance on accounts receivable and account closures
- Leverage data analytics to identify revenue leakage, denial trends, and inefficiencies
- Develop and maintain dashboards for KPIs (days in A/R, clean claim rate, denial rate, net collection rate)
- Use predictive analytics to forecast revenue trends and support strategic planning
- Conduct root cause analysis on underpayments, denials, and reimbursement delays
- Collaborate with IT and data teams to ensure data integrity and optimize reporting tools
- Present actionable insights to executive leadership
- Report to Diana Health CFO
Requirements
- Bachelor’s degree in Healthcare Administration, Finance, Business, or a related field
- Master’s degree (preferred) (e.g., MHA, MBA, MPH) with a focus on healthcare finance, analytics, or operations
- 10+ years of billing and coding experience, ideally in OB/GYN
- At least 10+ years of experience as a manager
- Experience working with health system operations
- Experience working under both FFS and Value based contracts
- Strong understanding of healthcare financial metrics and RCM performance indicators
- Ability to translate complex data into clear, strategic recommendations
- Exceptional leadership, communication, and problem-solving skills
- Advanced excel skills
- Start-up or entrepreneurial experience (preferred)
- Experience working in Athena’s practice management software (preferred)
- Experience with legal document review (preferred)
