Revenue Cycle Transformation Leader

Job Description

Job Description

Description:

The Revenue Cycle Transformation Leader is a senior executive-level operator responsible for driving enterprise-wide revenue cycle performance, financial outcomes, and operational transformation across complex healthcare organizations. This role is deployed into high-priority environments where performance, leadership alignment, and financial results are at risk. The individual is expected to take full ownership of the situation, rapidly assess performance, align executive stakeholders, and implement changes that deliver measurable and sustained impact.

Operating within highly complex and politically sensitive environments, this leader must influence at all levels of the organization — including CFO and executive leadership — while driving accountability across matrixed teams, vendors, and operational leaders. This individual functions as the de facto revenue cycle leader within client environments, setting direction, establishing governance, and ensuring that strategy translates into disciplined execution and tangible financial outcomes.

Success is defined by meaningful improvement in cash performance, reduction in AR and denials, alignment of leadership, and the establishment of sustainable operating models that persist beyond the engagement.

Duties and ResponsibilitiesRapid -Response Operations & Crisis Stabilization

• Knows, understands, incorporates, and demonstrates Healthrise's Core Values in all interactions with team members, clients, and stakeholders.
• Deploys on short notice to client sites or internal operations experiencing performance breakdowns, leadership vacancies, or go-live turbulence requiring immediate stabilization.
• Serves as interim operational lead for patient access, billing, AR, coding, denials, or client delivery functions when permanent leadership is absent, transitioning, or over capacity.
• Conducts rapid operational assessments within 48–72 hours of deployment: identifies root causes, surfaces risk, and presents a prioritized remediation plan to leadership.
• Establishes command and control within days of deployment by setting clear expectations, defining priorities and decision rights, and holding teams accountable.
• Takes ownership of operational breakdowns, escalated risks, and stalled workflows by directing teams, removing barriers, and restoring throughput.
• Establishes stabilization metrics and a daily communication cadence with senior leadership during crisis and highly visible engagements.
• Transitions stabilized operations back to permanent leaders with documented handoff plans, updated SOPs, and performance baselines in place.

Cross-Functional Revenue Cycle Execution

• Sets direction and oversees all revenue cycle functions (patient access, coding, billing, AR, denials, cash posting), stepping into hands-on execution selectively to accelerate stabilization or remove critical bottlenecks.
• Navigates multiple EMR/PM platforms (Epic, Cerner, Meditech, Athena, or equivalent) and adapts quickly to new systems, payer portals, and proprietary RCM tools.
• Supports quality reviews, documentation improvement initiatives, and denial root-cause analyses across HB and PB environments.
• Stays current on coding updates (CPT, ICD-10-CM, HCPCS), CMS billing guidelines, and payer policy changes that impact claim accuracy.
• Identifies structural breakdowns across people, process, technology, and reporting, and drives enterprise-level solutions.
• Aligns domestic, offshore, vendor, and client teams under a unified operating model.

Financial Performance Ownership

• Owns revenue cycle financial performance within assigned engagements, including cash collections, AR reduction, denial performance, and cost efficiency.
• Establishes performance targets tied to financial outcomes and holds teams accountable to achieving them.
• Identifies revenue leakage, margin opportunities, and cost inefficiencies, and implements corrective actions.
• Translates operational performance into financial impact, clearly linking initiatives to cash, margin, and cost improvement.
• Partners with executive leadership to align operational strategy with financial goals and organizational priorities.

Client Engagement & Relationship Support

• Builds rapid trust with client stakeholders through transparency, responsiveness, and demonstrated operational command, even in high-pressure environments.
• Acts as the senior-most revenue cycle leader within client environments when required, driving direction, alignment, and performance across executive and operational teams — while remaining willing to roll up sleeves and identify opportunities at any level.
• Engages directly with CFO, COO, and executive stakeholders to align on priorities, risks, and performance expectations.
• Leads or participates in executive business reviews (EBRs), operational steering committees, and client working sessions on behalf of senior leadership.
• Drives timely, high-impact executive communications by distilling complex issues into crisp, actionable insights and ensuring rapid alignment during fast-moving situations.
• Identifies and communicates client satisfaction risks, SLA exposure, and relationship red flags to leadership; develops and executes remediation plans.
• Supports new client onboarding, system conversions, and go-live activations as an embedded operational lead or subject matter expert.

Project Leadership & Strategic Initiative Execution

• Defines and drives the overall revenue cycle transformation strategy for assigned engagements, ensuring alignment with enterprise priorities and financial objectives.
• Leads or co-leads high-priority operational projects: service line launches, automation deployments, workflow redesigns, system integrations, and performance improvement initiatives.
• Ensures disciplined execution of transformation initiatives through clear milestones, accountability, and executive visibility.
• Applies Lean, Six Sigma, or equivalent continuous improvement methodologies to identify inefficiencies, eliminate waste, and design scalable operational solutions.
• Serves as subject matter expert and implementation lead for technology and automation initiatives (RPA, AI-assisted coding, prior auth tools, etc.) rolled out across client or internal operations.
• Produces executive-ready deliverables: performance dashboards, operational assessments, root cause analyses, project status reports, and post-implementation reviews.
• Ensures all initiatives are tied to measurable outcomes, including cash acceleration, denial reduction, productivity improvement, and cost efficiency.

Enterprise Leadership & Stakeholder Alignment

• Operates effectively within complex, multi-layered healthcare organizations with competing priorities, unclear ownership, and political sensitivities.
• Influences executive stakeholders (CFO, VP, Director-level) to align on priorities, remove barriers, and drive timely decision-making.
• Identifies organizational friction points, misaligned incentives, and leadership gaps that impact performance, and actively works to resolve them.
• Drives decision-making and accountability in environments where ownership is unclear or contested, ensuring commitments translate into execution.
• Holds senior stakeholders accountable to commitments and performance expectations.
• Navigates resistance, builds alignment where needed, and maintains forward momentum in ambiguous or high-pressure environments.

Interim People Leadership & Team Support

• Provides direct supervisory coverage for patient access, billing, AR, coding, or client delivery teams when permanent leadership is unavailable or in transition.
• Establishes leadership expectations, performance standards, and accountability structures across teams during periods of transition.
• Identifies skill gaps, performance concerns, and morale issues within deployed teams; escalates formally to HR and senior leadership as appropriate.
• Mentors leaders (Managers and above) in revenue cycle best practices, critical thinking, and professional development — leaving teams more capable than at the start of each engagement.
• Supports workforce planning, capacity management, and staffing gap analysis at the direction of senior leadership.
• Assesses leadership capability and recommends structural or personnel changes where needed.

Governance & Operating Model

• Establishes governance structures, reporting cadence, and escalation pathways to ensure visibility and accountability.
• Defines operating models that align people, process, and technology to drive sustained performance.
• Ensures consistent performance reporting and transparency across all levels of the organization.

Compliance, Quality & Continuous Improvement

• Ensures all revenue cycle activities remain in compliance with applicable federal and state billing regulations, HIPAA, payer policies, and organizational standards.
• Conducts or supports coding and billing audits; documents findings and implements corrective action in collaboration with compliance and clinical leadership.
• Develops, updates, and operationalizes SOPs, job aids, and training materials as a byproduct of each deployment, producing documentation for sustained performance.
• Identifies, recommends, and implements process improvements that are measurable, scalable, and sustainable beyond the immediate engagement.
• Maintains a working knowledge of applicable federal, state, and local laws and regulations.
• Performs other duties as assigned.

QualificationsRequired

• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field; or equivalent combination of education and progressive experience.
• Minimum 7+ years of progressive revenue cycle experience, including leadership accountability for operational and financial performance.
• Prior experience in a senior leadership capacity (Director, VP, or equivalent) with responsibility for performance outcomes within health systems, physician groups, or multi-entity organizations.
• Demonstrated ability to rapidly onboard into unfamiliar environments, systems, and client organizations and deliver results quickly without extensive ramp time.
• Broad functional knowledge across the full revenue cycle continuum: patient access, charge capture, coding (ICD-10/CPT/HCPCS), claim submission, AR follow-up, denials, underpayment recovery, and cash posting.
• Proven experience working in or supporting healthcare management consulting, BPO/outsourcing, or multi-client RCM services environments.
• Proficiency with Epic and strong ability to adapt to new systems quickly.
• Track record of driving measurable financial improvement (cash acceleration, AR reduction, denial reduction, margin improvement, productivity gains).
• Demonstrated experience operating in complex, politically sensitive healthcare environments with multiple executive stakeholders and competing priorities.
• Proven ability to influence without direct authority and drive outcomes across matrixed organizations.
• Experience presenting to and advising executive leadership (CFO, COO, VP-level stakeholders).
• Strong analytical skills: ability to assess operational performance, interpret AR and denial data, and translate findings into prioritized action plans within days of deployment.
• Exceptional written and verbal communication skills; comfortable presenting to executive-level stakeholders, client leadership, and frontline staff alike.
• High degree of professional adaptability, emotional intelligence, and composure in high-pressure, ambiguous, or politically complex environments.
• Ability and willingness to travel up to 75%, including short-notice deployment to client sites.
• Proficiency in Microsoft Office (Outlook, Word, PowerPoint, Excel).
• Completion of regulatory/mandatory certifications as required.

Preferred

• Master's degree (MHA, MPH, MBA, or equivalent).
• Certified Professional Coder (CPC), Certified Revenue Cycle Professional (CRCP), Certified Professional Biller (CPB), HFMA Fellow (FHFMA), or equivalent industry certification.
• Lean Six Sigma Green Belt or Black Belt; demonstrated experience facilitating rapid improvement events (kaizen, RCA workshops).
• Experience with AI/automation tools applied to revenue cycle (RPA, AI-assisted coding, prior authorization automation, intelligent denial routing).
• Demonstrated success leading system conversions, new client go-lives, or technology implementations from activation through steady state.
• Experience managing or mentoring staff across remote, hybrid, and onshore/offshore team structures.
• Familiarity with the No Surprises Act, price transparency requirements, and other recent regulatory developments affecting hospital and physician billing.

Physical Demands and Work Environment

• Work Environment: Operates in a variety of professional settings — corporate offices, client hospitals and health system campuses, remote home office, and travel environments. Must be comfortable adapting to new physical and technological environments quickly and frequently.
• Physical Demands: Largely a sedentary role; employees may need to use keyboards, mouse, and other devices for typing, clicking, and navigating software systems.
• Schedule: Standard business hours with flexibility required during crisis deployments, go-live activations, or client-driven escalations. Occasional evening or weekend availability may be required in high-urgency situations.

Requirements: