Director of Revenue & Financial Operations

Do Work That Matters. In a Culture That Means It.

Be part of a team that values connection, accountability, and real impact.

Why Access?

Because how we work matters just as much as what we do. At Access, our Culture Playbook isn’t a poster on the wall – it’s how we show up for each other and for the people we support.

You’ll be part of a team that is:

• Clear about expectations
• Supportive and accountable
• Focused on outcomes that matter to people.

And committed to helping people live the healthiest and fullest lives possible – while making sure out staff can do the same.

Location: Middletown, NY

Salary: $120,000 Annually

Hours: On-Site, Monday-Friday 8:00AM-4:30PM (40hrs)

Summary:
The Director of Revenue & Financial Operations plays a critical leadership role in overseeing the financial health of our multi-corporate structure, with a focus on revenue cycle management, financial reporting, and compliance. This position is responsible for managing the agency’s revenue cycle, including billing and collections for Medicaid Managed Care and other third-party payers, ensuring the financial sustainability of our $160 million nonprofit organization.

Overseeing the billing of upwards of $100 million annually, the Director ensures timely reimbursement and compliance with complex state and federal regulations. Working closely with the Chief Financial Officer (CFO), this role optimizes accounts receivable, enhances financial reporting, and ensures the accuracy of the Electronic Health Records (EHR) system. Leadership support for payroll functions and strategic financial planning are also key responsibilities.

This position requires deep expertise in behavioral health insurance billing, nonprofit financial management, and accounting principles, including general ledgers, account reconciliations, and journal entries.

Key Responsibilities:

• Oversee the agency’s revenue cycle, ensuring efficient billing and collections processes for Medicaid Managed Care, Medicare, and third-party payers.
• Manage billing operations for annual revenues exceeding $100 million, optimizing cash flow and revenue recognition.
• Provide leadership in financial planning, budgeting, and forecasting in collaboration with the CFO.
• Manage financial reporting, including corporate financial statements, consolidated fiscal reports, and audits.
• Ensure compliance with Medicaid Managed Care billing regulations and federal/state funding requirements.
• Maintain the accuracy and integrity of the Electronic Health Records (EHR) system as it relates to billing and revenue cycle operations.
• Analyze financial data, revenue streams, and cost centers to maximize profitability and operational efficiency.
• Assist in developing funding proposals and appeals to support program growth and financial sustainability.
• Support internal and external audits, identifying financial risks and implementing corrective actions.
• Lead and develop the billing and accounts receivable team, ensuring high performance and operational improvements.
• Monitor regulatory changes and advise executive leadership on financial impacts and opportunities.

Qualifications:

• Master’s degree in accounting, business management, or a related field with 5+ years of leadership experience in nonprofit financial management OR
• Bachelor’s degree in accounting, business management, or a related field with 8+ years of progressively responsible leadership experience in nonprofit financial management.
• Extensive experience in behavioral health insurance billing, particularly for Medicaid Managed Care.
• Strong knowledge of medical billing procedures, coding, Medicaid/Medicare regulations, Medicaid Managed Care Billing, and third-party reimbursement.
• Knowledge of Behavioral Health Net Smart
• Experience in nonprofit accounting, including general ledgers, journal entries, and account reconciliations.
• Familiarity with state and federal funding sources, particularly those related to mental health, residential, and rehabilitation services.
• Strong analytical skills to interpret financial data, develop reports, and guide decision-making.
• Excellent written, verbal, and presentation skills.
• Advanced computer literacy, including financial software proficiency.
• Proven ability to recruit, train, and lead a high-performing financial team.

What We Offer:

• Comprehensive medical (82% employer-funded), dental, and vision (free with dental) coverage.
• 403(b) retirement plan with up to 4% matching contributions, 100% vested after two years.
• Tuition reimbursement after three months.
• Employee discount program.
• Career growth opportunities in a growing nonprofit organization.

An Equal Opportunity Employer, including disability and Veterans