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Senior Manager, RCM Optimization – Strategy
InStride Health. Analyze end-to-end RCM workflows from pre-billing through denial resolution and patient collections .
Tech Stack
Tools & technologiesRPASQL
About the role
Key responsibilities & impact- Analyze end-to-end RCM workflows from pre-billing through denial resolution and patient collections
- Eliminate manual processes, remove operational bottlenecks, and address revenue leakage
- Design, test, and implement streamlined workflows with the Senior Director of RCM
- Own billing system setup and configuration across Apero, Sigma, and Mahler, including payor billing logic, fee schedules, and contract terms
- Build, maintain, and refine RCM KPI dashboards
- Audit billing engine rules, rule logic, and fee schedules for compliance with payor guidelines and coding updates
- Lead root-cause analyses on claim denials and underpayments
- Serve as the internal checkpoint for claims escalations before issues go to payors
- Partner with Technology teams on automation for claim submission, denials management, and revenue capture
- Partner with Payor Operations on systemic payor issues
- Manage internal and clearinghouse configuration rules to resolve pre-claim edits and front-end rejections
- Coordinate with Licensing & Credentialing, Authorization & Eligibility, Patient Access, and Clinical Operations to reduce claim errors and intake-driven denials
- Lead change management for new billing tools, software integrations, and workflow changes
- Deliver executive-level RCM insights, progress updates, and financial performance reporting
Requirements
What you’ll need- 6+ years of progressive healthcare revenue cycle management experience, with at least 3 years in an analytical, optimization, or process improvement capacity
- Bachelor’s degree in Healthcare Administration, Finance, Business Analytics, or a related field or 10+ years in healthcare RCM
- Proven track record of using complex data sets to streamline RCM operations, reduce claim denials, and recover lost revenue
- Strong project management background with demonstrated success leading cross-functional tech or process improvement projects
- Exceptional analytical and problem-solving skills with high attention to detail
- Clear written and verbal communication skills, with an ability to translate complex revenue cycle data into clear, actionable insights for diverse teams
- Highly collaborative mindset with proven ability to build effective relationships across clinical, operational, and technical leadership
- Working knowledge of insurance payor policies, billing guidelines, and claims submission requirements
- Familiarity with CPT and ICD-10 codes and how they impact billing and reimbursement
- Hands-on experience with payor contract analysis, fee schedule audits, and underpayment identification and recovery
- Experience configuring billing platforms; experience with Apero, Sigma, Mahler, or similar RCM software preferred
- Behavioral health or telehealth billing background preferred
- Previous experience in a fast-paced, high-growth, or startup healthcare environment preferred
- Hands-on experience building custom clearinghouse rules and RPA/AI solutions preferred
- Advanced technical mastery in SQL, BI reporting platforms, EHR/PM systems, and clearinghouse rule builders preferred
Benefits
Comp & perks- 401k with match
- Flexible PTO
- Paid holidays
- Paid service days
- 4 week paid sabbatical
- 12 week paid parental leave
- Health benefits starting on your first day
- Fully virtual work from home
- Periodic in-person retreats