RCM Architect

Job description

ABOUT JOYFUL HEALTH Building the financial operating system for healthcare — and bringing the joy back to healthcare by fixing the financial chaos behind it. The healthcare payment system is a complex and inefficient maze. Healthcare practices leave $125 billion in revenue uncollected each year, lost in the chaos of fragmented financial data, manual workflows, and opaque payer systems. This financial uncertainty leaves practices struggling to stay afloat while valuable revenue slips through the cracks. Joyful Health is building an AI-powered financial operating system for healthcare practices. Our mission is to bring the joy back to running a private practice by simplifying financial operations so providers can focus on patient care. We spent 10 months working as fractional CFOs for a dozen practices, doing this work side by side with providers as we developed our product. We just announced our $22M Series A led by CRV and world-class investors including the founders of MongoDB & KAYAK. At the center of our model is the RCM Center of Excellence (CoE) — the layer that translates real-world billing complexity into scalable systems. If you’re excited about applying deep RCM expertise to fix a system that is fundamentally broken, we’d love to meet you. THE ROLE We are hiring an RCM Architect to serve as the RCM knowledge layer across the organization. This is a high-leverage, cross-functional role that sits at the intersection of Sales, Customer Success & Operations, and Product & Engineering. You are the person who defines what correct RCM looks like — and ensures the organization is executing toward it. This role is accountable for outcomes, not just artifacts. RCM Architects are not measured by the quality of the document they produce — they are measured by whether the function, project, or account achieves its intended RCM result. You own the outcome. You will be responsible for translating RCM complexity into clear strategy, structured workflows, and actionable insights — ensuring that: - We start customers correctly - We build the right product - We solve the right problems - The organization develops a compounding understanding of RCM patterns and solutions WHAT YOU’LL DO The RCM Architect is the connective tissue between Joyful's RCM expertise and every team that depends on it. On any given day, you might be deep in a customer's denial data identifying the root cause of a revenue leakage pattern, sitting alongside Engineering to validate whether a new agent workflow reflects how billing actually works, or building the SOP that a BPO team will use to execute against a new specialty. This is not a role defined by a single function. You are embedded across Sales, Customer Success, Product, and Operations — not as a support resource, but as the person who sets the standard for what correct RCM looks like and ensures the organization is executing toward it. You own the outcome, not just the deliverable. - Audit claims and drive strategy — Review claims for accuracy of action taken, validate next-best-action decisions, and translate findings into systemic recommendations. You're not fixing one claim; you're identifying the pattern behind it. - Turn denial data into actionable workflows — Translate denial patterns into root causes and resolution pathways. Define standardized recovery strategies, escalation logic, and decision frameworks that hold up against real-world payer behavior. - Codify RCM knowledge at scale — Build and maintain the SOPs, specialty guides, and decision frameworks that allow the organization to execute at a high RCM standard without you in every room. You are building a system, not just answering questions. - Set every new customer up for success — Analyze denial rates, aging, payer mix, and workflow gaps at onboarding. Deliver a data-backed strategic action plan to the RCSM so every account starts with a clear path forward. - Enable the organization — Support new hire onboarding, partner with Product and Engineering on feature release training, and communicate industry changes with a clear summary of what they mean for each team. - Shape what gets built — Serve as the embedded RCM SME throughout the product development process. Contribute to PRDs, surface edge cases before build, and hold yourself accountable for the RCM quality of what ships — not just the feedback you submitted. - Power the sales motion — Provide pre-sales RCM analysis for deals within ICP, create specialty-specific enablement materials for AEs, and review outbound copy for accuracy and appropriate framing. - Be the expert in the room on escalations — Partner with RCSMs on complex customer challenges, step in when root cause is unclear, and feed systemic insights back into the product roadmap and operational workflows. HOW YOU’LL BE MEASURED Primary metric: Reduction in upheld denials and rejections — the clearest signal that actions taken are correct and effective. - Resolution effectiveness rate - Reduction in rework and incorrect actions - Time to resolution - Adherence to the historical backlog burndown rate — how successful was the strategic approach? - Product feedback tied to measurable outcomes — not just written feedback, but whether what you influenced actually improved results - Degree to which you can operate independently without Head of RCM review — a key signal that the function is scaling as intended WHAT SUCCESS LOOKS LIKE In 30–60 Days - Deep familiarity with Joyful’s workflows, product, customer base, and internal team structure - Producing clear, well-structured onboarding analyses for new customers with actionable recommendations - Contributing meaningfully to product conversations — opinions are grounded in real-world RCM, communicated with confidence - First SOPs and workflow definitions drafted and in review In 90 Days - Independently owning the onboarding support function for new customers without Head of RCM review - Actively identifying systemic denial patterns across the customer base and translating them into product improvements and SOPs - Recognized by Product and Engineering as a trusted RCM authority — your feedback is shaping what gets built - Sales team is relying on your pre-sales analysis to close and scope deals with confidence In 6–12 Months - The organization has a compounding, structured body of RCM knowledge — SOPs, enablement guides, denial frameworks — that scales beyond any single person - Measurable reduction in upheld denials across the customer base attributable to workflow and strategy changes you led - Product is building workflows that consistently reflect real-world RCM complexity because the CoE’s feedback loop is working - The CoE is emerging as a recognized center of expertise — the function other teams go to when things are hard WE’D LOVE TO HEAR FROM YOU IF… YOU HAVE - 8+ years in Revenue Cycle Management with deep expertise in denials, AR follow-up, and payer behavior - Hands-on experience analyzing claims data, denial trends, and revenue performance across multiple payers and specialties - Experience working across functions — you’ve collaborated with Sales, Operations, or Product teams, not just stayed in a billing lane - Experience designing or improving RCM workflows, SOPs, or decision frameworks — not just executing existing ones - A track record of using AI tools, automation, or data to work smarter. We expect every member of the CoE to be actively pushing the boundary of what’s possible with the tooling available to them. YOU ARE - A systems thinker — you think about root causes, patterns, and scalable solutions, not just the next action on a claim - Outcome-oriented — you care whether the thing you built actually worked, not just that you delivered it. You track results. - Comfortable being the person people go to when things are unclear — when root cause is murky, when the payer is behaving oddly, when the product doesn’t know what to do — you’re the one with a structured answer - Analytical and data-driven — you can go from raw data to insight to strategy to execution, and you do it naturally - Low ego, high ownership — collaborative and coachable, but you take accountability for outcomes. You don’t point to the artifact and consider the job done. - Product-minded — you think in systems and scalability. You see features not just as features but as encoded workflow logic — and you know when the logic is wrong. - A clear communicator across audiences — you can write a PRD comment that an engineer can act on, a briefing that an AE can deliver in a sales call, and an SOP that a biller can follow. These are different things, and you know the difference. - Comfortable with ambiguity and confident making calls — you don’t default to “maybe” when you mean “no.” You make a judgment, document your reasoning, and move forward. - Open to your role evolving — the RCM Architect role will begin as a generalist function and is expected to evolve toward specialization over time. You’re excited about shaping what that looks like, not threatened by it. WHY THIS ROLE MATTERS Most organizations treat RCM as a series of disconnected tasks. We treat RCM as a system that can be understood, structured, and improved. The RCM Architect is the role that makes that possible. When you define a workflow, audit a decision, or translate a denial pattern into a product requirement, you are building something that compounds. Every system you design, every piece of knowledge you codify, every SOP you write — it doesn’t just help one claim or one customer. It improves how the entire organization operates. This type of role doesn’t exist in traditional healthcare organizations. The RCM Architect isn’t just a biller or a consultant or a product manager — it’s a new function, built for a company that believes revenue cycle intelligence can be structured, scaled, and embedded into a product. OUR VALUE PROP TO YOU 🚀 Meaningful Impact You are not backfilling a seat in an RCM department. You are building the intelligence layer that defines how an AI-powered financial operating system understands and solves revenue cycle problems. Your expertise compounds into something bigger than any single customer or claim. 🔑 Ownership You own the RCM outcome, not just the deliverable. You have a direct line to the Head of RCM, direct influence on the product roadmap, and the trust to operate with real autonomy as you demonstrate independent judgment. 📈 Growth Gain deep exposure to: - AI product development in a way that almost no RCM professional ever gets - Cross-functional strategy — Sales, Product, Engineering, and Operations all rely on this role - RCM at scale — patterns across dozens of practices across multiple specialties, compounded into a growing body of knowledge 💰 Compensation & Equity Competitive salary + equity in a high-growth company backed by world-class investors. ❤️ Be Your Best Self Comprehensive healthcare benefits, unlimited PTO (with a minimum of 10 days off a year), flexibility, and a team that cares about doing this right. We organize regular team off-sites and invest in your professional development.