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 intricate or urgent patient financial matters that may hinder or interrupt 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 access to care.

• Supervise front-end revenue cycle operations, encompassing insurance verification, benefits analysis, prior authorization support, and patient cost estimation.

• Guarantee the prompt identification and resolution of coverage challenges before treatment begins.

• Collaborate with downstream RCM teams on coding, billing, collections, denial management, continuity, and accuracy.

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

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

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

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

• Recruit, train, mentor, and evaluate financial counseling staff across various sites or service lines.

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

• Serve as an operational partner to physicians, APPs, nursing leaders, and practice administrators.

• Convert financial and coverage information into actionable insights for care teams.

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

• Ensure that financial counseling activities adhere to regulatory, payer, and organizational standards.

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

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

⛳️ Requirements

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

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

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

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

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

• Experience in a large MSO, multi-site oncology practice, or complex specialty setting is desirable.

• Familiarity with EHR and RCM systems (e.g., Epic, Aria/Mosaiq, OncoEMR, or similar) is preferred.

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

• Understanding of ASP, WAC, AWP, and other drug pricing methodologies and their implications on charge capture and margins.

• Awareness of differences between Medicare Part B and Part D, as well as variations among commercial payers and 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 with myFlexPay.

• Flexible spending accounts (FSAs).

• Short- and long-term disability coverage.

• Work-Life resources.

• Paid parental leave.

• Healthy lifestyle programs.