Revenue Cycle Process Improvement Manager

Role Description

The Revenue Cycle Process Improvement Manager is responsible for leading operational and workflow improvement initiatives across the Central Billing Office (CBO). This role partners with revenue cycle leadership, operations, finance, IT, and clinical support teams to identify inefficiencies, reduce denials and rework, improve cash acceleration, strengthen controls, and standardize best practices across back-end revenue cycle functions. This role supports the Summit Revenue Cycle by driving measurable improvements in performance, accountability, and scalability.

• Lead revenue cycle process improvement initiatives across charge capture, billing, claims submission, payment posting, denials, follow-up, and customer service workflows.
• Evaluate current-state workflows to identify inefficiencies, bottlenecks, handoff failures, control gaps, and opportunities for standardization and automation.
• Design and implement future-state workflows, SOPs, tools, and operating controls that improve quality, throughput, and accountability.
• Apply structured improvement methods such as root cause analysis, workflow mapping, KPI management, and corrective action planning.
• Support system optimization, work queue redesign, edit logic improvement, and workflow standardization across facilities, teams, and service lines.
• Analyze operational and financial performance trends to identify opportunities to improve cash collections, reduce denials, lower days in AR, minimize rework, and strengthen clean-claim performance.
• Partner with revenue cycle and operational leaders to prioritize improvement efforts based on financial impact, operational risk, staffing burden, and patient experience.
• Monitor results after implementation to ensure process changes are adopted, sustained, and producing measurable outcomes.
• Support efforts to reduce avoidable write-offs, late charges, claim holds, missed authorizations, posting variances, unapplied cash, and preventable reimbursement leakage.
• Use data from host system platforms, clearinghouses, payer portals, work queues, and reporting tools to identify root causes of performance issues and develop actionable solutions.
• Prepare dashboards, scorecards, summaries, and leadership updates that measure initiative progress and operational impact.
• Conduct audits, workflow reviews, and variance analyses to validate compliance with expected processes and identify breakdowns by facility, payer, department, or team.
• Translate data findings into practical action plans, operational recommendations, and leadership-level decision support.
• Collaborate with Patient Access, HIM, Coding, Clinical Operations, Managed Care, Finance, Compliance, and IT to resolve upstream and downstream revenue cycle barriers.
• Lead or support cross-functional meetings, action plans, project workgroups, and implementation efforts tied to process redesign and operational improvement.
• Develop training tools, communication materials, and transition plans to support adoption of new workflows and operational expectations.
• Support integration, standardization, and stabilization efforts for new facilities, acquired operations, and organizational change initiatives.
• Ensure process improvement efforts align with payer requirements, billing regulations, documentation dependencies, internal policies, and audit expectations.
• Help strengthen operational controls related to claim quality, charge integrity, payment accuracy, denial prevention, and reconciliation workflows.
• Promote a culture of continuous improvement by identifying recurring issues, tracking trends, and building sustainable corrective actions.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Finance, Accounting, Industrial Engineering, or related field preferred; equivalent relevant experience may be considered in lieu of degree.
• Three or more years of progressive healthcare revenue cycle, operational improvement, project management, consulting, or related experience preferred.
• Experience leading workflow redesign, performance improvement, automation, or revenue cycle transformation initiatives preferred.
• Experience in hospital, behavioral health, acute care, physician revenue cycle, or multi-site healthcare operations preferred.
• Experience using host system platforms, reporting tools, clearinghouse data, and revenue cycle analytics preferred.
• Strong understanding of end-to-end healthcare revenue cycle workflows and common operational control points.
• Strong analytical, organizational, project management, and communication skills.
• Ability to interpret data, identify root causes, and translate findings into measurable process improvements.
• Experience with workflow mapping, standardization, policy development, and cross-functional implementation planning.
• Proficiency with Excel, reporting tools, payer portals, and standard revenue cycle systems.

Requirements

• This position is a remote position.
• This position is an individual contributor.

Benefits

• Comprehensive benefit plan.
• Competitive salary commensurate with experience and qualifications.