Manager, Revenue Cycle Management

Role Description

We are seeking a highly capable operator to build and lead Revenue Cycle Management at Daymark. This is a foundational role as we expand our primary care service lines. You will own the end-to-end revenue cycle function, including:

• Professional billing
• Third-party billing vendor management
• Claims operations
• Risk adjustment

While partnering closely with Clinical Operations, Finance, Product, and Data. The right candidate brings deep technical fluency in PCP-focused billing codes, hands-on experience managing billing vendors and clearinghouse platforms, and a forward-thinking orientation toward AI-enabled RCM. This role is ideal for someone who wants to build a function from the ground up and grow with it.

Qualifications

• Deep knowledge of PCP revenue cycle, including fluency with E&M, AWV, CCM, TCM, APCM, and PCM billing rules, documentation requirements, and reimbursement structures
• Direct experience managing a third-party billing vendor and a claims/clearinghouse platform
• Experience with HCC coding, risk adjustment suspecting, and chart review workflows
• Familiarity with AI applications in RCM and a genuine interest in applying them
• Experience at a startup or high-growth healthcare company is a plus

Requirements

• Own Daymark's Revenue Cycle Operations
• Lead end-to-end RCM across all payer types, with primary focus on Original Medicare and value-based contract populations
• Develop and maintain billing protocols for PCP service lines including E&M, Annual Wellness Visits (AWVs), Chronic Care Management (CCM), Transitional Care Management (TCM), and Advanced Primary Care Management (APCM)
• Establish patient billing workflows including statement generation, cost-sharing communication, and collections processes; ensure workflows are sensitive to the patient experience while maintaining collection integrity
• Manage the third-party billing vendor relationship, including performance monitoring, issue escalation, contract compliance, and ongoing optimization
• Own the claims and clearinghouse platform, including submission workflows, rejection and denial management, and resubmission processes
• Establish and track RCM KPIs: clean claim rate, denial rate, days in AR, net collection rate, and others
• Partner with Finance on revenue recognition, cash flow forecasting, and month-end close support
• Support accurate risk adjustment operations aligned with our care model and payer contracts
• Partner with Clinical Operations, Product and Data to ensure risk adjustment workflows are reflected in tooling and supported from pre-chart prep to documentation and through billing and claim submission
• Support end-to-end enrollment workflows for new providers, including NPI registration, CAQH profile maintenance, and payer-specific credentialing applications
• Track credentialing status and expiration timelines across the provider panel to ensure no gaps in billing eligibility
• Partner with Clinical Operations and People to build onboarding workflows that sequence credentialing milestones with provider start dates
• Identify and manage credentialing vendors or delegated credentialing arrangements where applicable
• Identify and evaluate AI-enabled tools across the RCM workflow, including automated coding assistance, denial prediction, and other capabilities
• Partner with Product and Data to pilot and implement capabilities that improve throughput and accuracy
• Translate billing and compliance requirements into scalable operational workflows
• Establish audit and QA processes to ensure coding accuracy and billing integrity
• Identify execution gaps and drive resolution across cross-functional teams

Benefits

• This role is fully remote, but will be expected to work on either Eastern or Central time zone hours
• Compensation: $120,000 - $135,000 annually, depending on location & experience