01Key Responsibilities
Strategic Leadership & Governance:- Provide strategic direction and long-term vision for Healthcare RCM operations- Own operational P&L, margins, productivity metrics, and cost optimization initiatives- Drive standardization, best practices, and continuous improvement across RCM processes- Partner with executive leadership on growth strategy, capacity planning, and expansionCompliance, Risk & Quality:- Ensure compliance with HIPAA, HITECH, CMS regulations, and payer guidelines- Oversee internal and external audits and corrective action plans- Implement strong data security, access controls, and governance frameworks- Own quality assurance frameworks and continuous quality improvement programsFinancial & Performance Management:- Track and improve KPIs including AR days, first-pass yield, denial rates, productivity, and cost per claim- Manage budgets, forecasting, and resource utilization- Drive revenue growth through operational efficiencies and upsell opportunitiesRequired Skills & Qualifications:Experience & Education:- 10 years of experience in Healthcare Revenue Cycle Management operations- Proven experience managing large-scale offshore RCM delivery for US healthcare clients- Bachelor's degree in Healthcare Administration, Business, Life Sciences, or related field- Master's degree (MBA / MHA) preferredCore Leadership & Business Skills:- Strong strategic thinking and decision-making abilities- Deep understanding of US healthcare reimbursement models- Excellent client-facing, communication, and executive presentation skills- Proven ability to manage P&L and drive operational profitability- Strong change management and transformation leadershipTechnical & Domain Skills:- Healthcare RCM Expertise- In-depth knowledge of US healthcare RCM workflows and payer rules- Strong understanding of Medicare, Medicaid, and Commercial payer processes- Expertise in denial prevention, root cause analysis, and recovery strategiesTechnology & Analytics:- Experience with leading RCM platforms (Epic, Cerner, Athena, eClinicalWorks, Meditech, NextGen, etc.)- Exposure to RPA, AI, and analytics-driven RCM transformation- Strong command of MIS, dashboards, and operational reportingCompliance & Quality:- Expert-level understanding of HIPAA, PHI handling, and data security- Experience managing audits, SOC, and compliance frameworks- Strong QA governance and risk mitigation capabilitiesKey Performance Indicators (KPIs):- Reduction in AR days and denial rates- Improvement in cash collections and first-pass yield- SLA adherence and quality scores- Client satisfaction and retention- Margin improvement and cost optimization .
