Director, Revenue Cycle Management

Job description

**Director, Revenue Cycle Management** **Location:** Remote (U.S.) **Employment type:** Full-time **Reports to:** Chief Operating Officer **Compensation:** $140k **About the role** SimpliFed is looking for a Director of Revenue Cycle Management (RCM) to own the full revenue cycle end-to-end — and to build it properly, not just run it. This is a hands-on leadership role at a company in the middle of meaningful change. We are migrating to a new EHR (Healthie), rebuilding our configuration in Candid Health, and establishing a clean, trustworthy data foundation underneath both. The person in this seat will lead that work, then own the operating rhythm that comes after it. We are looking for a true RCM expert — someone who has personally configured payer rules, worked denials, defended a cash forecast, and can tell us what we are doing wrong. You will be the company’s authority on revenue cycle, and you will be given the mandate to act like it. **What you’ll own** - **End-to-end revenue cycle.** Eligibility and benefits verification, charge capture, coding, claim submission, denial management, appeals, AR follow-up, patient billing, and cash posting. - **The Candid Health build.** Own configuration, payer rules, fee schedules, and claim edits. Establish a monitoring cadence and modify rules based on what the data actually shows — not what was assumed at setup. - **EHR transition.** Serve as the revenue cycle lead on the Healthie implementation. Ensure clinical documentation, encounter data, and charge flow map cleanly into billing, and manage the cleanup and resolution of legacy claims from the prior system. - **Data integrity.** Establish and maintain a single source of truth for payer, plan, provider, and contract data. Clean data is a precondition for everything else here, and it is a core part of this job. - **Forecasting and reporting.** Build revenue cycle reporting leadership can rely on: cash forecast, AR aging, denial trends by payer and reason code, and yield by service line. Own the numbers and the explanation behind them. - **Payer relationships.** Manage escalations, underpayments, and payer performance. Partner closely with the team that owns credentialing and payer enrollment to keep the provider roster current and billable, and flag downstream billing impacts early. - Lead, support, and develop a small RCM team, including an existing RCM Manager. Set priorities, remove blockers, and build the capacity to scale without adding headcount linearly. **What success looks like** - **First 90 days:** You are learning quickly, have assessed the current state, identified where revenue is leaking, and produced a prioritized remediation plan with owners and dates. - **First six months:** Candid is configured correctly and monitored, the Healthie transition is complete from a billing standpoint, legacy claims are resolved or you have a plan of action, and reporting is trusted. - **Ongoing:** Clean claim rate, first-pass yield, denial rate, days in AR, and net collection rate are measured, improving, and forecastable. **What we’re looking for:** **Required** - 7+ years in healthcare revenue cycle, with 3+ years leading a team or function - Deep professional (physician/practitioner) billing experience — not solely facility/hospital - Hands-on ownership of a modern billing or claims platform (Candid Health strongly preferred; Waystar, Availity, Office Ally, Change/Optum, or similar considered) - Demonstrated experience through an EHR implementation or migration, on the revenue cycle side - Fluency with CPT, HCPCS, ICD-10, modifiers, and payer-specific billing requirements - Track record of reducing denials and days in AR, with evidence you can walk us through - Comfort working with messy data — able to reconcile, validate, and build structure where none exists - Direct experience managing commercial payer escalations, underpayments, and performance issues **Preferred** - Telehealth, virtual care, or digital health billing experience - Familiarity with preventive services and ACA-mandated coverage, including lactation and maternal health benefits - Healthie experience - Comfort with SQL, BI tools, or spreadsheet modeling at depth - Startup or small-company experience — you are willing to do the work yourself, not just direct it **What we offer** - A remote-first team and a role with real scope and autonomy - Direct access to leadership and the mandate to change how things are done - The chance to build a revenue cycle function correctly from the ground up, at a company whose work meaningfully improves outcomes for new parents and infants **Compensation and Benefits** - Salary: $140K - Unlimited PTO plus company holidays - 401(k) eligibility. - Remote-first, with the flexibility that comes with it. **How we work** This role sits inside our RCM and collections function and works closely across operations, finance, clinical, and product teams. Expect a fast pace, direct feedback, and a team that would rather fix the root cause of a denial than resubmit and hope. **About SimpliFed** SimpliFed gives parents the tools they need to navigate baby feeding questions, concerns, and obstacles, starting in pregnancy and through the feeding journey. Our platform, mOS, connects families to licensed lactation and maternal health providers through partnerships with DME suppliers, health systems, and OB practices. We're a Series A company growing fast, and our operational and revenue infrastructure needs to grow with us. **About You** - Aligned with SimpliFed’s mission. - Hankering to put the relationships back in medicine - A posture towards execution - a true operator willing to both develop the strategy and execute it. - Ability to work remotely and communicate asynchronously via slack and email, along with thriving in virtual meetings. - Does not suffer in silence: willingness to give it a shot but then reach out for help as needed and not waiting too long. - Leans into items they are uncomfortable with, not avoid it. - Defers to safe and secure security protocols always to protect SimpliFed’s patients and providers. - High personal integrity to always do the right thing for the families that we are honored to serve. - Respect and high tolerance for bureaucracy, along with an optimistic perspective on how to operate within the bureaucratic “rules” and the healthcare regulatory environment. - Ability to work in a fast paced, team environment. - Have a valid Drivers License and REAL ID - Applicants must be currently authorized to work in the United States on a full-time basis *SimpliFed is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic.*