Director, Revenue Cycle

Description:

Title: Director, Revenue Cycle Management

Reports to: Senior Vice President, Finance

Department/Location: Revenue Cycle Management

FLSA Status: Exempt

Summary:

The Director of Revenue Cycle Management (RCM) is responsible for leading and optimizing the end-to-end revenue cycle for Guidelight Health. This role will focus on advancing and standardizing existing processes across the full lifecycle - from patient access and benefit verification through coding, billing, collections, and denial management - to support Guidelight’s next phase of growth.

This Director will drive performance improvements, enhance operational rigor, and ensure accuracy, timeliness, and compliance across all revenue cycle functions. This individual will partner cross-functionally with clinical, operations, and finance teams to identify opportunities for increased efficiency, scalability, and revenue capture. The ideal candidate brings strong leadership experience, a deep understanding of healthcare billing practices and payer requirements, and a proven track record of improving revenue cycle performance within a growing healthcare organization.

Responsibilities:

• Revenue Cycle Oversight: 
  • Manage the end-to-end revenue cycle process, including prior-authorization, utilization review, billing, collections, and accounts receivable management. 
  • Develop and implement policies and procedures to improve the efficiency and effectiveness of revenue cycle operations. 
  • Devise and build strong internal processes and documented workflows in support of the revenue cycle and ensure appropriate integration with field operations and patient medical records. 
  • Continually seek ways to improve the delivery and support of revenue cycle activities and strategize with operations leaders to proactively identify process improvement and eliminate barriers to success. 
• Billing and Collections: 
  • Oversee accurate and timely submission of claims to insurance payers and government programs. 
  • Monitor accounts receivable aging reports and work with the collections team to resolve outstanding balances. 
• Compliance and Regulations: 
  • Ensure compliance with federal, state, and local regulations related to billing and revenue cycle management. 
  • Stay updated on changes in healthcare regulations, payer requirements, and coding standards relevant to behavioral health. 
• Team Leadership: 
  • Hire, lead, and mentor the revenue cycle team, fostering a culture of continuous improvement and professional growth. 
  • Implement productivity goals, measures and/or tools to ensure teammates are performing at an appropriate level. 
  • Conduct regular training sessions on billing procedures, coding updates, and compliance issues for revenue cycle and facility-based teammates.  
• Data Analysis and Reporting: 
  • Lead the establishment and implementation of KPIs for revenue cycle operations and oversee the measurement and reporting of KPIs. 
  • Analyze revenue cycle metrics and KPIs to identify trends, areas for improvement, and opportunities for increased efficiency. 
  • Prepare and present regular reports to senior management on revenue cycle performance, challenges, and initiatives. 
• Collaboration: 
  • Work closely with clinical teammates, financial analysts, and IT departments to enhance revenue cycle processes and ensure seamless operations. 
  • Collaborate with external auditors and compliance officers during audits and reviews. 
  • Manage external vendors to ensure service delivery is in compliance with Statement of Work. 
• Strategic Planning: 
  • Participate in strategic planning initiatives to enhance the financial performance of the organization. 
  • Recommend and implement technology solutions that improve revenue cycle processes and client experience. 

Qualifications:

• Bachelor's degree in healthcare administration, Finance, Business Administration, or a related field. Master’s degree preferred. 
• Minimum of 5 years of experience in revenue cycle management, with at least 2 years in a supervisory or management role, preferably in a behavioral health setting. 
• Strong understanding of billing practices, coding, and payer requirements specific to behavioral health care. 
• Proficiency in revenue cycle management software and electronic health record (EHR) systems. 
• Knowledge of relevant regulations and compliance standards (e.g., HIPAA, Medicare/Medicaid requirements). 
• Excellent leadership, communication, and interpersonal skills. 
• Flexibly and adaptability to meet the diverse needs of clients in a fast-paced environment.  

*Please do not contact our public clinical admissions line regarding this or any other job posting. For recruiting-related inquiries, please contact the Talent team at Talent@guidelighthealth.com

Guidelight is an Equal Opportunity Employer. We are passionate about fostering an environment where everyone, irrespective of their race, gender, sexual orientation, or background, feels valued and included.

We want to be a place where every employee has a voice and feels truly welcome, appreciated, free to be themselves, and empowered and enabled to do their best work. Our differences make us unique, and we actively support these differences and work to create communities of respect throughout our company. www.guidelighthealth.com