Director of Revenue Cycle Management

Director Of Revenue Cycle

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 difference in others' lives. Individuals who align with our five pillars: Compassion, Acceptance, Respect, Empowerment, Stewardship should join us.

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.

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.