Manager, RCM Operations & Analytics

Accountabilities: Performance Intelligence & Reporting Own standardized RCM KPI definitions, data sources, targets, controls, and reporting for key metrics such as days in accounts receivable (AR), AR aging, clean claim rate, first-pass resolution, denial and rejection rates, net collection rate, charge lag, and payment posting timeliness. Establish independent and timely visibility into transaction volumes, work queues, processing status, productivity, quality, and backlogs across internal teams and business process outsourcing (BPO) partners. Collaborate with Product, Engineering, Clearinghouse, and vendor teams to improve data access, reconciliation, accuracy, and reporting automation. Deliver actionable dashboards, operating reviews, trend analyses, root-cause findings, and recommendations at client, portfolio, and vendor levels. Identify at-risk clients, revenue leakage, denial patterns, and operational bottlenecks, and track corrective actions through to verified results. Operational Excellence & Process Improvement Lead cross-functional improvement initiatives across charge capture, claims processing, denials, AR follow-up, payment posting, onboarding, and credentialing and enrollment handoffs. Map current and future workflows, identify inefficiencies and rework, and partner with operations leaders to establish scalable processes and standard operating procedures. Develop quality measurement and audit frameworks, analyze results, and recommend workflow or training improvements. Measure onboarding performance and time-to-value for new RCM clients, including readiness, early production performance, and stabilization. Manage improvement initiatives from business-case development through implementation, adoption, and validation of results. Vendor & BPO Performance Management Partner with the Vendor Manager to define, validate, and report vendor service-level agreements (SLAs), transaction volumes, productivity, turnaround times, accuracy, and quality measures. Develop consistent vendor scorecards for weekly reviews and quarterly business reviews, using reconciled source data wherever possible. Quantify performance gaps, recommend corrective actions, and monitor progress with vendor and operations stakeholders. Support transaction forecasting, work allocation, staffing assumptions, vendor transitions, and contract negotiations through data-driven analysis. Reconcile vendor invoices against contracted rates, eligible transaction types, and verified volumes, identifying discrepancies and potential savings. Unit Economics, Capacity & Financial Performance Build and maintain transaction-level cost models and unit economics by client, service, function, and BPO partner. Track actual versus modeled vendor savings, cost-to-collect, service margins, and productivity in collaboration with Finance. Develop capacity and throughput models to inform vendor allocation, staffing decisions, and backlog recovery plans. Recommend opportunities to improve gross margin while protecting cash collections, service quality, and client experience. Technology, Automation & Cross-Functional Partnership Identify and prioritize automation, AI, workflow, and reporting opportunities that reduce manual work, improve first-pass yield, and increase operational visibility. Translate operational needs into business requirements, support user acceptance testing (UAT), and measure benefits after deployment. Analyze payer and clearinghouse edit performance and recommend improvements in collaboration with the teams responsible for technical rule ownership. Partner with Service Management on client-facing insights, Finance on forecasts, and Sales and Implementation teams on demand planning and onboarding capacity. Monitor payer policy and compliance-related trends, identify operational risks, and support process updates with relevant subject-matter experts. Requirements: At least 5 years of healthcare Revenue Cycle Management experience, including substantial experience with end-to-end ambulatory RCM workflows. At least 3 years of experience in RCM analytics, performance management, or operational improvement, with a demonstrated record of implementing measurable changes. Proficiency in SQL and/or a business intelligence platform such as Power BI, Tableau, or Looker. Advanced Excel skills and strong data validation capabilities. Experience evaluating outsourced or offshore BPO performance, including SLAs, quality, and transaction-level productivity. Ability to reconcile data from multiple sources, build actionable financial and operational models, and communicate findings to senior stakeholders. Working knowledge of payer reimbursement, claims processing, denials, AR management, and relevant billing requirements. Strong cross-functional collaboration, stakeholder influence, project execution, communication, and problem-solving skills. Preferred Qualifications: Experience working in a multi-client RCM services organization, ideally supporting ambulatory or multi-specialty practices. Familiarity with electronic health record (EHR) and practice management (PM) systems, clearinghouses, and DrChrono. Experience with transaction-based vendor pricing, invoice reconciliation, margin analysis, and capacity planning. Hands-on experience using AI-assisted analytics, reporting automation, or RCM workflow automation. Relevant training or certifications such as Lean, Six Sigma, CRCR, CRCS, CPC, or CPB. Additional Requirements: Must be authorized to work in the United States without employer sponsorship. Ability to work remotely from anywhere in the United States, with optional access to an office for candidates located near one. Willingness to travel occasionally to the corporate headquarters in Denver, Colorado, or other office locations across North America. Benefits: Annual base salary: $80,000–$90,000 USD in most U.S. locations. Final compensation may vary based on location, local market conditions, experience, and expertise. Flexible work arrangements, with the option to work remotely, in-office, or in a hybrid setup within the country of employment. Comprehensive health and wellness benefits available from the first day of employment. Annual wellness stipend. 401(k) retirement plan with up to a 4% employer match and immediate vesting. Flexible and generous flexible time off (FTO). Employee Stock Purchase Program. Ongoing professional development opportunities.