Director of Revenue Cycle Management

Job Description

Job Description

ARE YOU INTERESTED IN ASSISTING WITH BUILDING A SENIOR MANAGEMENT TEAM? LIGHTSHARE BEHAVIORAL WELLNESS AND RECOVERY is looking for individuals who would like to help us make a different in others' lives. Individuals who align with our five pillars: Compassion, Acceptance, Respect, Empowerment, Stewardship should join us.

Position Summary

The Director of Revenue Cycle is responsible for overseeing front-end revenue cycle functions to ensure accurate, timely, and compliant reimbursement for services. This role supervises Revenue Cycle Specialists and leads front-end financial processes including eligibility verification, funding assignment, and authorization management.

In a behavioral health and Centralized Receiving System (CRS) environment, the Director of Revenue Cycle plays a critical role in ensuring proper alignment between clinical services, funding sources (e.g., Medicaid, DCF/Managing Entity, grants), and billing practices. This position works in close collaboration with Operations, Resource Navigators and the Controller to ensure seamless coordination between front-end processes and downstream billing functions, while maintaining a clear separation of responsibilities. This position will also oversee contract/grant billing functions to maximize revenue integrity and compliance.

Position Summary

The Director of Revenue Cycle is responsible for overseeing front-end revenue cycle functions to ensure accurate, timely, and compliant reimbursement for services. This role supervises Revenue Cycle Specialists and leads front-end financial processes including eligibility verification, funding assignment, and authorization management.

In a behavioral health and Centralized Receiving System (CRS) environment, the Director of Revenue Cycle plays a critical role in ensuring proper alignment between clinical services, funding sources (e.g., Medicaid, DCF/Managing Entity, grants), and billing practices. This position works in close collaboration with Operations, Resource Navigators and the Controller to ensure seamless coordination between front-end processes and downstream billing functions, while maintaining a clear separation of responsiblities. This position will also oversee contract/grant billing functions to maximize revenue integrity and compliance.

Key Responsibilities

Revenue Cycle Oversight

Oversee front-end and revenue cycle functions, including:

Eligibility verification

Authorization management

Funding assignment

Ensure services are billed to the correct payer source (Medicaid, insurance, DCF/CFBHN, grants)

Team Leadership & Supervision

Supervise and support Revenue Cycle Specialist and UM Supervisor

Provide training, coaching, and performance management

Establish clear expectations, workflows, and accountability

Foster a culture of accuracy, compliance, and continuous improvement

CRS & Front-End Financial Integrity

Ensure intake and eligibility processes support clean claims and proper funding assignment

Maintain clear separation between clinical decision-making and financial determination

Collaborating with Clinical Leadership and Resource Navigators to align workflows

Compliance & Risk Management

Ensure adherence to:

HIPAA

Medicaid/Medicare regulations

DCF/CFBHN guidelines

Maintain audit readiness and support internal/external audits

Identify and mitigate revenue and compliance risks

Cross-Functional Collaboration

Partner with (healthcare)

Clinical leadership

CRS/Access teams

Resource Navigators

Finance department

Ensure alignment between service delivery, documentation, and reimbursement

Qualifications

Education

Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required

Experience

5+ years of experience in healthcare revenue cycle management

Experience in behavioral health, nonprofit, or DCF-funded environments strongly preferred

Prior supervisory experience required

Experience managing outsourced billing vendors preferred

Skills & Competencies

Strong knowledge of:

Medicaid, Medicare, and managed care billing

DCF/Managing Entity funding models

Excellent analytical and problem-solving skills

Strong leadership and team development abilities

Ability to interpret data and drive performance improvements

Effective communication and cross-functional collaboration

Key Performance Indicators (KPIs)

Days in Accounts Receivable (A/R)

Clean Claim Rate

Denial Rate & Resolution Time

Net Collection Rate

Funding Assignment Accuracy

% of Services Successfully Billed

Work Environment

Office-based with collaboration across clinical and administrative teams

May require flexibility to support operational needs

Summary

This role serves as the bridge between clinical operations and financial performance , ensuring that services delivered are accurately funded, compliant, and fully reimbursed .