Revenue Cycle Optimization Program Manager Stamford American International Hospital
- $74.73–$99.04 Per Hour
Job Title:
Director of Revenue CycleDepartment:
Health Care Center (HCC) Administration (Nicole Werner)FLSA:
United States of America (Exempt)Location:
Philadelphia Campus
EXECUTIVE SUMMARY:
The Director of Revenue Cycle is accountable for the end-to-end financial performance of PCOM’s clinical revenue cycle, from patient access through cash reconciliation. This role ensures revenue integrity across a diverse, multi-site clinical enterprise that includes primary care, geriatrics, osteopathic manipulation (OMM), behavioral health, and satellite locations.
This position serves as the primary owner of revenue cycle strategy, operations, and vendor governance, including direct oversight of the external billing partner (EMP Claims) and payer performance. The Director partners closely with Finance, Clinical Leadership, Practice Operations, and IT to improve performance, standardize workflows, and support growth.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Revenue Cycle Leadership & Ownership
Own the end-to-end revenue cycle across all PCOM clinical sites and service lines
Establish consistent front-end and back-end revenue workflows
Identify, quantify, and remediate revenue leakage
Ensure timely, accurate, and compliant billing and collections
Ensure revenue cycle processes align with applicable payer requirements, including Medicare, Medicaid, and relevant federal regulations
Provide oversight and guidance for patient access and scheduling workflows to ensure eligibility verification and registration accuracy support clean claims
Vendor Governance & Performance Management
Serve as the primary relationship owner for the external billing partner (EMP Claims)
Define and manage SLAs, KPIs, and performance expectations
Lead regular vendor performance reviews and escalation processes
Distinguish root causes between documentation issues, operational breakdowns, vendor execution, and payer behavior
Recommend vendor or contract changes when performance does not meet expectations
Payer Contract Insight & Revenue Integrity
Interpret payer contracts to ensure accurate reimbursement and identify underpayment trends
Partner with Finance to assess financial impact of payer terms and reimbursement methodologies
Support evaluation of payer performance and inform contract strategy and renegotiation priorities
Financial Performance & Reporting
Own and monitor key revenue cycle metrics, including:
Days in Accounts Receivable
Denial rate and denial root causes
Net collection percentage
Charge lag and claim submission timeliness
Develop leadership-ready dashboards and insights, not just raw reports
Translate revenue data into actionable recommendations for Finance and Executive Leadership
Clinical & Operational Partnership
Partner with clinical leadership to improve documentation and coding accuracy, including faculty and learner environments
Support service-line specific needs (e.g., OMM, geriatrics, nursing home services)
Collaborate with practice operations to improve front-desk workflows, eligibility verification, and registration accuracy
Serve as a trusted advisor across Finance, Operations, and Clinical teams
Revenue Cycle Strategy & Readiness
Prepare revenue cycle infrastructure for:
New sites and satellite locations
New or evolving service lines
Changes in payer mix or reimbursement models
Support evaluation and potential transition of cash-pay services to insurance-based models (e.g., behavioral health)
Develop a 12–18-month revenue cycle roadmap aligned to PCOM’s clinical growth strategy
REQUIRED SKILLS AND EXPERIENCE:
Experience in healthcare revenue cycle operations, preferably in a multi-site or multi-service environment
Strong understanding of end-to-end revenue cycle workflows, including charge capture, coding, billing, and collections
Working knowledge of CPT, ICD-10, and reimbursement methodologies sufficient to identify documentation, coding, and payment issues
Demonstrated experience managing or overseeing a third-party billing partner
Experience working within an electronic medical record (EMR) environment to support revenue cycle operations; familiarity with NextGen a plus
Experience interpreting payer contracts and reimbursement methodologies to support revenue cycle performance
Ability to identify underpayments and contract variances through data analysis
Ability to translate complex revenue data into actionable insights
Strong cross-functional communication and influence skills
Preferred Qualifications
Experience in academic medical, ambulatory, or mixed clinical environments
Familiarity with primary care, geriatrics, or procedure-based services (e.g., OMM)
Experience supporting growth or operational transformation initiatives
Starting Salary: $97,528 annually
The referenced salary range is based on PCOM good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level. PCOM offers a total rewards package that supports our employees' health, life, career and retirement.
PCOM prohibits discrimination on the basis of age, race, sex, color, gender, gender identity and expression, national origin, ethnicity, ancestry, sexual orientation, religion, creed, disability, genetic information, marital status, pregnancy, military and military veteran status or any other legally protected class status in all its programs, activities, and employment practices.
| Location | Philadelphia, Pennsylvania |
