Analysis Skills, Artificial Intelligence (AI), Billing, Billing Records, Business Operations, Cardiology, Clinical Medicine, Communication Skills, Content Management Systems (CMS), Credit and Collections, Cross-Functional, Current Procedural Terminology (CPT), Data Quality, Detail Oriented, Documentation, Documentation Standards, English Language, External Audit, Healthcare, Internal Audit, Leadership, Maintain Compliance, Management Strategy, Medical Billing, Medicare, Metrics, Onboarding, Operations Management, Performance Analysis, Presentation/Verbal Skills, Problem Solving Skills, Process Development, Process Improvement, RMON, RPM, Registered Nurse (RN), Regulations, Reporting Dashboards, Revenue Management, Sales Management, Support Documentation, System Operations, Team Lead/Manager, Team Player, Use Cases, Writing Skills
Director of CCM/RPM Operations
Owns the end-to-end operational backbone of CCM and RPM programs across multiple physician practices — covering billing, compliance, reporting, and account management.
Sector
Healthcare Operations — Chronic Care Management & Remote Patient Monitoring
Reports to
Senior Leadership
Type
1099 Independent Contractor (with potential conversion to W-2)
Hours
Full-time · US Central / Eastern business hours (Texas-based preferred)
Location
Remote · Must overlap with US Central/Eastern time zones
Tools
Akos, HealthSnap, Prevounce, Optimize Health (familiarity helpful); standard billing and reporting tools
Role Overview
Our client is seeking a Director of CCM/RPM Operations to lead and own the full operational infrastructure of their care management programs. This is a high-impact, builder-stage role responsible for billing performance, CMS compliance, reporting infrastructure, and practice-level account management across multiple physician groups.
The successful hire will be someone who designs systems, solves operational problems, and scales what works — not just an operator who manages existing workflows. This role sits at the intersection of clinical care, revenue, compliance, and practice relationships.
Key Responsibilities
Billing & Revenue Cycle
- Own CCM/RPM billing performance and integrity across all partner practices
- Ensure documentation supports billing requirements; monitor claim accuracy and reduce denial rates
- Work with internal teams and external billing partners to improve collections and streamline processes
- Define workflows for complex billing scenarios: straddle-month billing, corrections, and audit documentation
Compliance & Audit Readiness
- Ensure all programs adhere to CMS guidelines for CCM, RPM, PCM, and TCM — including supervision requirements and documentation standards
- Build and maintain audit-ready workflows at all times
- Lead internal audits and prepare for external audits
- Translate regulatory updates into operational changes
Program Operations & Performance
- Oversee operational performance across practices; define and track key metrics (enrollment growth, engagement, billable utilization, device compliance)
- Identify bottlenecks and implement process improvements
- Ensure alignment between clinical workflows, platform capabilities, and billing requirements
Reporting & Analytics
- Build and manage reporting across operational, financial, and practice-level performance
- Develop dashboards, ensure data accuracy, and translate insights into actionable recommendations
- Support billing validation, compliance monitoring, and executive decision-making
Account Management & Practice Success
- Serve as senior operational point of contact for physician practices
- Support onboarding, monitor performance, and identify growth opportunities
- Build strong relationships with physicians and practice administrators
Cross-Functional Leadership
- Collaborate with clinical leadership, care management teams, and product/technology partners
- Design systems that scale as the organization grows
Who Will Succeed in This Role
The right candidate brings deep CCM/RPM expertise combined with a high ownership mindset and comfort operating in a fast-moving build-stage environment. They design systems, fix what's broken, and scale what works — without needing a fully defined playbook to get started.
- High ownership orientation — treats the programs as if they personally built them
- Comfortable operating with ambiguity; builds structure where none exists
- Detail-oriented without losing sight of the bigger operational picture
- Strong communicator who can work directly with physicians and practice administrators
- Analytically strong — turns data into decisions, not just reports
Experience & Skills
Required:
- 7–10+ years in healthcare operations with direct CCM and/or RPM program experience
- Strong background in revenue cycle management, Medicare Part B billing, and care management operations
- Deep knowledge of CCM/RPM CPT codes: 99490, 99439, 99487, 99489, 99453, 99454, 99457, 99458
- Fluency with documentation requirements, time-based billing rules, and supervision models
- Experience working with physician practices; cardiology, MSO, CIN, or VBC background preferred
- Prior experience leading programs or teams
- AI fluency — actively uses AI tools to work faster and smarter; must be able to speak to specific tools and use cases at screening
- Strong written and verbal communication — exceptional written English; assessed at screening
- Must be able to work during US Central/Eastern business hours
Preferred:
- Experience in cardiology or with cardiac patient populations
- Hands-on experience with RPM device programs
- Familiarity with Akos, HealthSnap, Prevounce, or Optimize Health
- Value-based care or ACO model experience
- Clinical background (RN, NP, or similar) — beneficial but not required