This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director of Revenue Cycle Management & Credentialing based in United States.
This is a senior operational leadership role responsible for driving the financial backbone of a fast-scaling virtual cardiology organization.
You will own end-to-end revenue cycle management and provider credentialing across a multi-state, multi-payer healthcare environment.
The role ensures accuracy, efficiency, and performance across billing, claims, collections, and payer enrollment processes.
You will lead both internal teams and external vendors while building scalable systems that support rapid growth in clinical operations.
A strong focus is placed on data-driven performance improvement, denial reduction, and cash flow optimization.
In parallel, you will oversee credentialing strategy to ensure uninterrupted provider enrollment and payer network integrity.
Accountabilities:
- Own end-to-end revenue cycle management including charge capture, claim submission, denial management, AR follow-up, payment posting, and patient billing
- Oversee RCM operations across internal teams and external vendors, including SLA management, performance tracking, and escalation handling
- Develop and optimize scalable RCM workflows, improving automation, reducing manual processes, and increasing financial visibility across clinical operations
- Build and maintain reporting dashboards covering denial trends, AR aging, reimbursement rates, payer performance, and collection KPIs
- Lead initiatives to reduce denial rates, accelerate cash collections, and improve net revenue performance
- Manage and evolve the mix of internal and external RCM resources to support organizational scaling needs
- Lead the credentialing and payer enrollment function, ensuring timely onboarding, re-credentialing, and compliance across all states and payers
- Ensure data integrity across credentialing systems, payer portals, and billing platforms (e.g., CAQH and EMR systems)
- Partner cross-functionally with clinical, finance, technology, and leadership teams on strategic RCM and credentialing initiatives
- Support audits, compliance reviews, payer expansion, and new clinical program launches
Requirements:
- Bachelor’s degree in Healthcare Administration, Business, Finance, or related field (advanced degree preferred)
- 7+ years of progressive experience in healthcare revenue cycle management, including leadership responsibilities
- Proven experience managing both RCM operations and provider credentialing/payer enrollment functions
- Strong background in multi-state, multi-payer healthcare environments; telehealth or virtual care experience strongly preferred
- Experience managing vendor relationships and internal teams with SLA oversight and performance accountability
- Strong knowledge of end-to-end claims workflows, including clearinghouses, billing systems, and ERA processing
- Deep understanding of government and commercial payer enrollment processes (Medicare, Medicaid, VA, Tricare, etc.)
- Familiarity with credentialing systems and payer platforms such as CAQH
- Strong analytical skills with the ability to translate operational data into executive-level insights and reporting
- Excellent communication and stakeholder management skills across clinical, operational, and executive teams
- Highly organized with strong project management skills and ability to manage multiple complex workstreams simultaneously
Benefits:
- Competitive compensation package with performance-based incentives
- Comprehensive medical, dental, and vision insurance coverage
- Remote-first work environment with strong flexibility and autonomy
- Opportunity to contribute to mission-driven, high-impact cardiovascular care innovation
- Strong culture of collaboration, inclusion, and mutual support
- Fast-paced, agile environment focused on continuous improvement and innovation
- Opportunity to build and scale critical operational functions in a high-growth healthcare organization