Senior Director RCM

Job Title: Senior Director, Revenue Cycle Management

Position Type: Full Time

Work Setting: Hybrid

Department: Core Ops: RCM - Leadership

Reports to: VP, Revenue Cycle Management

FLSA:  Salary, Exempt

ABOUT VAXCARE

The healthcare system is complex, presenting challenges for everyone—patients, doctors, nurses, office managers, and billers alike. At VaxCare, we aim to streamline this complexity, eliminating unnecessary costs and confusion so that practices can focus on their important work: caring for patients. Our innovative solutions include a vaccine management and LARC access platform trusted by over 20,000 active providers nationwide. This service is powered by a multidisciplinary team of dedicated professionals who lead with integrity and a relentless drive to exceed expectations, bringing clarity and efficiency to the often-overwhelming world of healthcare.

THE POSITION

The Senior Director of Revenue Cycle Management (RCM) will lead backend revenue cycle operations for a national vaccine administration organization operating across 44 states. This role is heavily focused on denial management, accounts receivable optimization, and scalable workflow design in a high-volume environment processing over 5 million claims annually.

The ideal candidate brings deep expertise in denial management operations, clearinghouse workflows, and the broader RCM technology ecosystem, coupled with a strong track record of driving process improvement and automation. This role will also require a working understanding of how billing platforms integrate with multiple partner EHR systems to support a distributed care delivery model.

ESSENTIAL RESPONSIBILITIES

Revenue Cycle Operations

• Lead day-to-day operations across the full revenue cycle, including: 
  • Patient registration and eligibility
  • Charge capture and coding
  • Claims submission and clearinghouse management
  • Payment posting, AR follow-up, and denial management
• Manage throughput and performance in a high-volume claims environment with a focus on accuracy, timeliness, and scalability
• Establish and monitor KPIs (e.g., clean claim rate, days in AR, denial rate, net collection rate)

Technology & Systems Optimization

• Serve as a strategic leader in RCM technology and systems, including EHRs, practice management systems, and clearinghouses
• Partner with IT and vendors to: 
  • Design and optimize charge routing, payer logic, and claim edits
  • Implement automation, AI, and workflow tools to improve efficiency
  • Lead system upgrades, integrations, and process redesign initiatives

Denials & Payer Strategy

• Drive enterprise denial management strategy: 
  • Root cause analysis and remediation
  • Payer-specific workflow optimization
• Partner with payer contracting and compliance teams to ensure alignment with: 
  • Vaccine billing requirements (including CMS, state Medicaid variations, and commercial payer policies)
  • Timely filing and documentation standards

Compliance & Regulatory Oversight

• Ensure adherence to federal and state billing regulations across 44 states
• Maintain audit-ready processes for CMS, Medicaid, and commercial payer requirements
• Oversee compliance related to vaccine administration billing, including counseling, preventive services, and modifier usage

Leadership & Team Development

• Lead and develop high-performing RCM teams (onshore/offshore as applicable)
• Establish accountability through clear performance expectations and regular reporting cadence
• Drive continuous improvement culture focused on scalability and quality

Cross-Functional Collaboration

• Partner with clinical operations, finance, IT, and external vendors to align revenue cycle strategy with organizational growth
• Support executive leadership with reporting, forecasting, and decision support related to revenue performance

REQUIRED EXPERIENCE & QUALIFICATIONS

Medicare, Medicaid, and commercial payer billing

Denial management and AR optimization

End-to-end RCM workflows

EHR systems

Clearinghouses ()

Revenue cycle analytics and reporting tools

COMPETENCIES: Core to all positions at VaxCare

We Live (and Work) by Our Values:

- Building a team culture founded on trust, collaboration, and delivery excellence

- Belief in Something Bigger than Ourselves – Capacity to derive meaning from a larger purpose

- Humility as a Posture of Learning – Burning curiosity to learn without ego

- Adaptability & Embracing Change – Nimbleness & ready to seize new opportunities

Additional “Must Haves”:

- Dependability – Must be able to meet deadlines, work independently, maintain focus, & punctual

- Interpersonal Skills – Builds strong relationships & contributes to a positive work environment.

- Computer Skills – Skilled with computers, learns new tools quickly.

- Ethics – Honest, accountable, maintains confidentiality.

OTHER RESPONSIBILITIES

• Commute to Office: Must be able to commute to and from the corporate office for each scheduled shift.
• Prolonged sitting or standing: Team members must be able to remain in a stationary position for extended periods, as much of the work involves sitting at a computer or workstation. Some hybrid or office-based roles may also require the ability to stand for portions of a shift.
• Repetitive motions: Significant use of the hands, wrists, and fingers is required for tasks like typing, using a computer mouse, and handling paperwork.
• Visual acuity: This job requires the ability to view a computer screen and read documents for extended periods.
• Communication: Team members must be able to clearly express and exchange ideas in English to effectively communicate with customers and co-workers.
• Occasional lifting: Many office-based jobs specify the ability to occasionally lift or move up to 10-20 pounds to handle supplies or equipment.