Director of Revenue Cycle

Vitra Health Director Revenue Cycle

Vitra Health is a mission-driven healthcare organization committed to improving the quality of life for individuals and families across Massachusetts. Through innovative home- and community-based services, Vitra supports aging adults, people with disabilities, and individuals with complex care needs—supported by a Nurse, and Case Manager, Vitra ensures clients receive compassionate, personalized, and dignified care.

To help share our mission and expand our community impact, Vitra Health is seeking a Director Revenue Cycle who is passionate about community engagement and helping people access the care and resources they deserve.

The Opportunity

The Director of Revenue Cycle is responsible for leading and overseeing all revenue cycle activities, processes, and functions across Vitra Health. This role ensures compliance with all applicable federal and state regulations, payer requirements, and industry best practices while driving operational excellence throughout the revenue cycle. The Director is accountable for monitoring, analyzing, and maintaining key revenue cycle performance metrics, identifying opportunities for process improvement, revenue optimization, and operational efficiency. Through strategic leadership and continuous performance evaluation, this position supports the organization's financial health and commitment to delivering exceptional service.

Key Responsibilities

• Lead and oversee all Revenue Cycle Operations functions, including billing, collections, accounts receivable, denial management, payment posting, and reimbursement activities.
• Monitor key revenue cycle metrics, analyze trends, and implement strategies to optimize revenue, cash flow, operational efficiency, and reimbursement performance.
• Ensure compliance with all federal and state regulations, payer requirements, coding standards, Electronic Visit Verification (EVV) requirements and industry best practices.
• Partner with the Compliance function on all billing-related matters, ensuring that MassHealth Adult Foster Care (AFC) and Group Adult Foster Care (GAFC) billing practices adhere to 130 CMR 408.000 and 130 CMR 450.000, including conditions for payment, prior authorization, non-covered days, medical and nonmedical leave-of-absence limits, and supporting documentation requirements, and engage Compliance in the review of billing policies, void and adjustment activity, and any identified billing irregularities.
• Direct accounts receivable and denial management processes, including aging reviews, write-offs, reconciliation activities, and collection strategies.
• Own authorization and reauthorization management, including tracking approaching expirations, coordinating timely reassessments, and minimizing revenue loss from lapsed or denied authorizations.
• Partner with Finance and Operational leaders to support revenue forecasting, payer relationships, contract strategy, financial reporting, and process improvement initiatives.
• Lead payor contracting, negotiations and analysis of financial impact of managed care contracts and fee schedules in partnership with Finance leadership.
• Develop and maintain revenue cycle policies, procedures, controls, and reporting to drive accuracy, accountability, and continuous improvement.
• Maintain and present standing revenue cycle reporting, including KPI dashboards, AR aging, denial trends and payor performance to executive leadership on a regular cadence.
• Lead, coach, and develop Revenue Cycle team members through performance management, training, mentoring, and employee engagement initiatives, including planning for adequate coverage during staffing transitions or absences.
• Ensures compliance workplan is up to date and aligned with State and Federal compliance requiremetns
• Collaborate with internal departments, external vendors, and payer representatives to resolve reimbursement issues and improve revenue cycle performance.
• Support internal and external audits while ensuring accurate documentation and adherence to compliance requirements.
• Serve as a champion of Vitra Health's mission, values, customer service standards, and commitment to quality care for the communities we serve.
• Perform other duties and special projects as assigned.

What We Are Looking For:

Education & Experience

• Bachelor's degree in Business Administration, Finance, Accounting, Healthcare Administration, or a related field required.
• Minimum of five (5) years of progressive experience in healthcare revenue cycle, patient accounting, billing, collections, reimbursement, or related functions.
• Minimum of three (3) years of leadership experience managing revenue cycle, billing, or patient financial services teams.
• Experience working with healthcare billing systems, payer reimbursement methodologies, and revenue cycle analytics.
• Healthcare financial or revenue cycle certifications (HFMA, AAHAM, or equivalent) preferred.

Knowledge, Skills & Abilities

• Strong knowledge of healthcare revenue cycle operations, including billing, collections, accounts receivable, payment posting, denial management, and reimbursement processes.
• Thorough understanding of federal, state, and payer regulations, coding requirements, and compliance standards including Medicaid managed care and value-based care models.
• Proven ability to analyze data, identify trends, develop reports, and implement process improvements that drive financial performance.
• Strong financial, analytical, problem-solving, and decision-making skills.
• Experience developing and implementing policies, procedures, controls, and operational workflows.
• Effective leadership, coaching, and team development capabilities.
• Excellent communication, collaboration, and relationship management skills.
• Proficiency with revenue cycle software, reporting tools, and Microsoft Office Suite, particularly Excel.
• Commitment to customer service, continuous improvement, and Vitra Health's mission and values.

Work Environment and Physical Requirements

• Office-based work in a clean well-lit environment with fluctuating temperatures near others.
• Client-facing field staff and community liaisons require frequent travel to client homes or community settings; ability to drive safely; work in client homes may involve varying temperatures, odors, allergens, pets, and other environmental factors.
• Requires substantial periods of repetitive work utilizing a computer, monitor, keyboard, and mouse.
• Requires lifting and carrying equipment and supplies weighing up to 35 pounds; requires pushing and pulling equipment and supplies weighing up to 35 pounds; requires walking and standing; requires frequent sitting more than 75% of the workday; requires the ability to negotiate stairs; requires visual acuity and manual dexterity to operate equipment.

Perks and Benefits:

• Employer sponsored health insurance with a generous employer match.
• Dental and vision benefits.
• Supplemental benefits including life, accident, critical illness, and disability insurance.
• 401K with a 5% company match.
• Accrued paid-time-off.
• Ten company paid holidays.
• Wellness benefits.
• Tuition reimbursement.
• Supportive team structure and company culture with a focus on work/life balance.

Vitra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.