Manager, Revenue Cycle Management

This is a fully remote position, open to applicants in California.

📋 Description

• Lead a team of financial counselors offering real-time assistance to patients, physicians, nurses, and care coordinators throughout the oncology care continuum.

• Act as an escalation point for complex or urgent patient financial matters that may hinder or delay care.

• Ensure that financial counseling services are integrated into clinical workflows to facilitate same-day decisions and treatment initiation.

• Advocate for a patient-centered approach that balances financial transparency, empathy, and accessibility to care.

• Supervise front-end revenue cycle operations, including insurance verification, benefits interpretation, prior authorization assistance, and patient cost estimation.

• Guarantee the prompt identification and resolution of coverage challenges prior to the commencement of treatment.

• Collaborate with downstream Revenue Cycle Management (RCM) teams covering coding, billing, collections, and denial management.

• Track key performance indicators (KPIs) related to access, counseling timeliness, authorization turnaround, point-of-service collections, and financial clearance rates.

• Manage screening and enrollment processes for manufacturer assistance, charity care, grants, and foundation support programs.

• Maintain expertise in oncology-specific reimbursement, benefit designs, and evolving payer policies.

• Ensure the compliant and consistent application of financial assistance guidelines and documentation.

• Recruit, train, mentor, and assess financial counseling personnel across various sites or service lines.

• Develop standard operating procedures and best practices for patient and provider support.

• Promote communication, accountability, and excellence in service within the team.

• Collaborate with physicians, advanced practice providers (APPs), nursing leaders, and practice administrators.

• Translate financial and coverage information into actionable advice for care teams.

• Participate in clinic leadership meetings and cross-functional initiatives aimed at enhancing access, growth, and patient experience.

• Ensure adherence to regulatory, payer, and organizational requirements.

• Assist with internal and external audits related to financial clearance, authorizations, and assistance programs.

• Continuously enhance processes to minimize administrative burdens on clinical teams and patients.

• Oversee department operations, supervise staff, develop policies and procedures, ensure adherence to guidelines, resolve operational challenges, and achieve consensus among stakeholders.

⛳️ Requirements

• Bachelor's degree in healthcare administration, business, finance, or a related field (or equivalent experience) is preferred.

• A minimum of 5 years of progressive experience in healthcare revenue cycle or financial counseling, ideally in oncology.

• At least 3 years of experience in people management or team leadership is preferred.

• Strong familiarity with insurance plans, oncology benefits, prior authorizations, and patient financial responsibilities is preferred.

• Proven ability to work directly with clinical teams in fast-paced care environments.

• Experience in a large Management Services Organization (MSO), multi-site oncology practice, or complex specialty setting.

• Knowledge of Electronic Health Record (EHR) and RCM systems (e.g., Epic, Aria/Mosaiq, OncoEMR, or similar) is essential.

• In-depth understanding of oncology drug reimbursement models, including buy-and-bill, specialty pharmacy carve-outs, and alternative funding pathways.

• Familiarity with ASP, WAC, AWP, and other drug pricing methodologies and their effects on charge capture and margin.

• Understanding of Medicare Part B vs. Part D, variations among commercial payers, and differences in site-of-care reimbursement.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off plan.

• Health savings account (HSA).

• 401k savings plan.

• Access to wages before payday through myFlexPay.

• Flexible spending accounts (FSAs).

• Short- and long-term disability coverage.

• Work-Life resources.

• Paid parental leave.

• Healthy lifestyle programs.