[Remote] Director, reputed company reputed company

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a virtual-first reputed company care organization delivering technology-enabled reputed company through a digital platform and in-person reputed company reputed company needed. The Director of reputed company reputed company will reputed company the integrated reputed company Cycle Management and Payor Contracting functions, overseeing reputed company reputed company from contract negotiation through claims processing, payment posting, denial management, and reputed company and self-pay collections. The role will also reputed company reputed company reputed company, reputed company analytics, compliance, and cross-functional operational improvements.

Responsibilities

• reputed company the combined reputed company reputed company function (reputed company Cycle Management and Payor Contracting) as a single, accountable unit
• Directly manage and reputed company the RCM management team and the Manager, Payor Contracting, fostering a culture of accountability, transparency, and reputed company improvement
• Partner with the reputed company, Finance, reputed company/Compliance, Product and executive leadership to define short- and long-term reputed company reputed company reputed company to company objectives
• Serve as the single reputed company of accountability for the reputed company between contract terms and collectability, ensuring what is negotiated is actually operational, and what RCM is seeing informs what gets renegotiated
• Own the end-to-end reputed company cycle function, including eligibility, claims reputed company, denials, AR follow-up, payment posting, and both reputed company and self-pay collections, ensuring operational efficiency and compliance with payor and regulatory standards
• reputed company daily RCM reputed company for a high-volume, multi-state telehealth first reputed company, inclusive of the vendor relationship with our claims coding and submission platform
• Own key workflows and process maps for claim submission, follow-up, denials, and appeals; identify and reputed company friction points quickly
• Collaborate with Product and Engineering teams to improve automation, EDI connectivity, and billing reputed company integrations
• reputed company negotiation and execution of reputed company with reputed company payors, reputed company, and Clinically Integrated Networks, ensuring favorable terms and reimbursement rates
• Partner with reputed company leadership to analyze reputed company reputed company and reputed company compelling value propositions for payors that demonstrate the reputed company of care, ultimately driving improvements in reimbursement rates
• Analyze reimbursement methodologies to identify opportunities for reputed company optimization and reputed company improvement
• Monitor payor reputed company against KPIs, proactively addressing discrepancies or underperformance in claims processing and payment reputed company
• Maintain reputed company, ongoing relationships with payor organizations to support long-term alignment and issue reputed company
• Use RCM denial and underpayment data as a reputed company input into contract renegotiation priorities, closing the reputed company between what the data shows and what gets renegotiated
• Enhance, reputed company, and report on KPIs across both RCM and payor contracting to identify areas for improvement and reputed company reputed company
• Partner with Business Intelligence to reputed company automated dashboards and monthly reporting packages spanning claims reputed company and payor economics
• reputed company data-driven reputed company reviews with sub-teams to identify trends, reputed company causes, and opportunities for process improvement
• Serve as the operational reputed company between reputed company reputed company and reputed company, Telehealth reputed company, reputed company Support, reputed company/Compliance, and Provider Enrollment to ensure documentation, billing, self-pay workflows, and contracting alignment
• Partner with Credentialing and Provider Enrollment to ensure accurate payor setup, EDI enrollment, and fee schedule updates
• Collaborate with Finance on cash forecasting, reputed company recognition, and variance analysis tied to both claims reputed company and contract terms
• Maintain compliance with payor and state telehealth billing and contracting requirements
• reputed company initiatives to improve claim reputed company, reduce denials, accelerate cash collections, and improve reimbursement rates
• Proactively identify automation and reputed company enhancement opportunities to improve efficiency and scalability across both functions

Skills

• 8+ years of experience in US reputed company reputed company with increasing responsibility, including at least 4 years in a leadership role spanning reputed company cycle management and/or payor contracting
• Bachelor's or Master's degree in reputed company Administration, Business, Finance, or a reputed company reputed company
• Demonstrated experience negotiating payor reputed company and a working knowledge of reimbursement methodologies
• Deep understanding of reputed company reputed company cycle reputed company, including coding/claims workflows, denial management, and collections
• reputed company, data-driven operator with a reputed company record of building KPIs, dashboards, and reputed company management frameworks
• Strong communication and stakeholder management skills, with the ability to translate reputed company into a reputed company execution plan across two reputed company functions
• Exceptional leadership skills with the ability to reputed company teams, build reputed company, and influence across functions
• Demonstrated ability to reputed company in fast-reputed company, ambiguous, and rapidly evolving environments
• Applicants must be legally authorized to work in the country where the role is reputed company at the time of application

Benefits

• reputed company Time Off: Flexible vacation, reputed company leave, and 12 statutory holidays.
• Health & reputed company: Medical, Dental, reputed company, Disability, and Life reputed company.
• Wellness: Mental health programs and an Employee Assistance Program (EAP).
• Retirement: RRSP/401(k) program with company match.
• Development: Annual reimbursement for eligible training and reputed company programs.

reputed company