Operations Director, Revenue Cycle Management

Role Description

Under the general direction of the Operations Senior Director, the Operations Director, Revenue Cycle Management (RCM) provides strategic leadership for our RCM Operations, supporting both internal and external clients. This role is accountable for establishing the operational vision, priorities, and strategies that enable scalable, compliant, and high-performing Admissions and RCM functions across the organization.

This leadership role will serve as a senior liaison and strategic partner to client leadership, third-party billing vendors, and internal stakeholders, ensuring alignment between strategy, payer requirements, operational execution, and financial outcomes.

Responsibilities

• Enterprise RCM Strategy & Governance:
  • Define and lead the enterprise strategy and operating model for payer management, admissions, and revenue cycle support, ensuring consistency, scalability, and financial integrity across all clients.
  • Establish governance frameworks, standards, and controls to support clean revenue, payer compliance, and operational excellence.
  • Provide executive-level guidance on RCM risk, performance trends, and improvement opportunities.
• Payer Strategy & Oversight:
  • Set the strategic direction for payer contract management, ensuring contracts are operationalized effectively to support accurate benefit verification, billing, and collections.
  • Oversee payer change management strategy, including prioritization, risk mitigation, and cross-functional coordination for payer updates across the client base.
  • Provide executive oversight for payer audits, ensuring timely, compliant, and effective responses while identifying systemic improvement opportunities.
• Operational Leadership & Team Enablement:
  • Lead and develop RCM operational leaders responsible for admissions, billing, and collections, ensuring the organization has the capability, structure, and talent to execute at scale.
  • Establish performance expectations, success metrics, and accountability models for RCM operations leadership.
  • Partner with HR and functional leaders on workforce planning, leadership development, and succession strategies for RCM teams.
• Client & Stakeholder Partnership:
  • Serve as a trusted advisor to client executives and internal leadership, translating operational performance into strategic insights and recommendations.
  • Foster strong cross-functional relationships to align RCM operations with clinical, finance, IT, compliance, and client engagement strategies.
  • Support client growth initiatives, including new Ambulatory Infusion Center (AIC) implementations, by ensuring RCM readiness and operational scalability.
• Process Optimization & Innovation:
  • Drive a continuous improvement mindset across RCM operations, leveraging automation, technology enablement, and data-driven decision making.
  • Sponsor and prioritize enterprise initiatives that reduce manual effort, improve cash flow, and enhance the client and patient experience.
  • Evaluate and influence RCM technology strategy in partnership with IT and product teams.
• Performance Management, Reporting & Compliance:
  • Provide executive-level oversight of RCM performance metrics, including receivables, aging, cash flow, and payer trends.
  • Translate operational and financial data into strategic insights for senior leadership.
  • Ensure enterprise compliance with regulatory, payer, and financial requirements; lead organizational readiness for regulatory or payer changes.

Qualifications

• Bachelor’s degree in Finance, Accounting, Business Administration, or related field desired; High School Diploma or GED required.
• At least 8 years of progressive experience in home infusion Revenue Cycle Management, healthcare operations, or financial operations, including leadership at the manager or director level strongly desired.
• Demonstrated experience leading large, complex operational functions or multi-client environments (home infusion experience strongly preferred).
• Strong understanding of healthcare billing, reimbursement, regulatory requirements, and financial controls.
• Proven success leading operational transformation, scaling teams, or implementing enterprise initiatives.
• Strategic, analytical mindset with the ability to balance long-term vision and operational outcomes.

Benefits

• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Company Description

As part of Evernorth Health Services, this role supports CarepathRx within our Pharmacy and Care Delivery organization. Our teams are ambitious, compassionate experts dedicated to advancing specialty pharmacy and infusion services in partnership with hospitals and health systems—always with patients at the center of what we do.