Revenue Cycle Management (RCM) Program Director

The Director partners with senior leadership, state agencies, and payer organizations to align operations with financial goals, oversees key metrics and reporting, manages complex Medicaid/Medicare billing requirements, ensures audit readiness, and guides technology optimization within Epic and related systems to continuously improve efficiency and accountability. DHHS is seeking a Revenue Cycle Management (RCM) Program Director to provide leadership and strategic direction for all end to end revenue cycle operations across DSOHF facilities, including patient access, health information management, coding, billing, accounts receivable, payer management, and collections.

DHHS is seeking a Revenue Cycle Management (RCM) Program Director to provide leadership and strategic direction for all end to end revenue cycle operations across DSOHF facilities.

DHHS is seeking a Revenue Cycle Management (RCM) Program Director to provide leadership and strategic direction for all end to end revenue cycle operations across DSOHF facilities, including patient access, health information management, coding, billing, accounts receivable, payer management, and collections. This role drives strategy to optimize financial performance, ensure regulatory compliance, minimize denials, and improve cash flow while guiding a multi tiered team of managers and staff. The Director partners with senior leadership, state agencies, and payer organizations to align operations with financial goals, oversees key metrics and reporting, manages complex Medicaid/Medicare billing requirements, ensures audit readiness, and guides technology optimization within Epic and related systems to continuously improve efficiency and accountability.

Skills set:

• Knowledge of full healthcare revenue cycle operations (patient access, HIM/coding, billing, A/R, denials).
• Understanding of Medicaid, Medicaid Managed Care, Medicare, and commercial payer reimbursement.
• Experience leading enterprise revenue cycle teams with managers and specialized staff.
• Ability to develop and execute revenue cycle strategy aligned with financial and compliance objectives.
• Expertise managing KPIs such as A/R days, denial rate, clean claims, and net collections.
• Strong knowledge of CMS, HIPAA, state regulations, and payer policies.
• Skill in maintaining internal controls, audit readiness, and compliance frameworks.
• Proficiency with Epic revenue cycle systems (Prelude, Cadence, Resolute HB/PB) and workflow governance.
• Ability to lead technology optimization, analytics, automation, and reporting.
• Strong partnership and collaboration skills across finance, clinical operations, IT, compliance, and payer organizations.
• Executive communication ability to present complex financial, operational, and regulatory information.
• Financial acumen to evaluate trends, forecast cash, assess reimbursement risks, and drive improvements.
• Competence in leading organizational change, standardization, and continuous improvement initiatives.
• Understanding of revenue cycle considerations for behavioral health, psychiatric care, developmental disabilities, and state-operated facilities.

Required/Desired Skills

Skill	Required /Desired	Amount	of Experience
Knowledge of full healthcare revenue cycle operations (patient access, HIM/coding, billing, A/R, denials).	Required	5	Years
Understanding of Medicaid, Medicaid Managed Care, Medicare, and commercial payer reimbursement.	Required	5	Years
Experience leading enterprise revenue cycle teams	Required	5	Years
Expertise managing KPIs such as A/R days, denial rate, clean claims, and net collections	Required	5	Years
Strong knowledge of CMS, HIPAA, state regulations, and payer policies.	Required	5	Years
Proficiency with Epic revenue cycle systems (Prelude, Cadence, Resolute HB/PB) and workflow governance.	Required	5	Years
Executive communication ability	Required	5	Years
Understanding of revenue cycle considerations for behavioral health, psychiatric care, developmental disabilities, and state-operated facilities.	Required	5	Years

Questions

No.	Question
Question1	Absences greater than two weeks MUST be approved by CAI management in advance, and contact information must be provided to CAI so that the resource can be reached during his or her absence. The Client has the right to dismiss the resource if he or she does not return to work by the agreed upon date. Do you agree to this requirement?
Question2	Onsite work will be expected once per quarter. Do you agree to this requirement?
Question3	Your candidate must be able to attend an in-person interview. Do you agree to this requirement?
Question4	What is your candidate's email address?
Question5	How soon can your candidate start if selected for this opportunity?
Question6	Vendors are encouraged to submit candidates that are available for the duration of the assignment. Do you anticipate your candidate being able to work until the proposed end date listed on this VectorVMS req?
Question7	Vendors must disclose to the agency if the candidate will be subcontracted at the time of submission. Is your candidate an employee of your company or a subcontractor? Please be sure to notify a CAI Account Manager if your candidate's employee status changes.
Question8	Vendors must notify the agency if any portion of the requirements listed in this task order will be outsourced to other countries. Do you anticipate outsourcing any work being done for this assignment to another country?
Question9	Candidates submitted above the hourly Vendor Rate of $$$ may not be considered for this assignment. Do you agree to this requirement?
Question10	Payment for all approved hours will be paid at the straight hourly rate regardless of the total hours worked by the engaged resource. It is the responsibility of the Vendor to adhere to any applicable compensation laws including payment for overtime hours. Do you agree to this requirement?
Question11	Have you thoroughly validated, and attest to the accuracy of, the credentials listed throughout your candidate s VectorVMS profile and resume pursuant to Section 5.2.5 of ITS-009440?