Director of Payer Ops and RCM
New
A
Alpaca HealthHealthcare
We prefer NYC-based candidates (or candidates open to relocation), but are open to remote candidates for this role as well.Full-TimeDirector
Salary160,000 - 200,000 USD per year
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Job Details
- Experience
- 7-10+ years experience in operations with at least 5 years working in commercial payor contracting and revenue cycle operations
- Required Skills
- Data AnalysisOperations Management
Requirements
- 7-10+ years experience in operations.
- At least 5 years working in commercial payor contracting and revenue cycle operations.
- Experience applying to and executing payor contracts.
- Successful negotiation experience securing higher reimbursement rates with quick turnaround.
- Experience running Revenue Cycle Management and building systems with high claims acceptance rates.
- Experience evaluating, onboarding, and managing external vendors/tools.
- Excellent cross-team collaboration and management skills.
- Strong business acumen and data analysis capability.
- Healthcare industry experience, particularly in pediatric care or related fields.
Responsibilities
- Accountable for performance of the entire revenue cycle including collections, denial rate, clean claim rate, and days in A/R.
- Recruit, develop, and lead a high-performing RCM team and oversee external vendors.
- Architect end-to-end workflows to eliminate revenue leakage across intake, eligibility, authorization, documentation, and coding.
- Lead strategy for payer performance, contracting, and reimbursement negotiations.
- Serve as executive partner to Product & Engineering to embed revenue intelligence into the platform.
- Design operating systems to handle rapid expansion across states and payers with automation.
- Establish a metrics-driven culture and define KPIs for real-time revenue performance visibility.
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