Advisor, Managed Care, Revenue Cycle Management System Administration

What Managed Care contributes to reputed company

Practice Operations Management oversees the business and administrative operations of a medical practice.

Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, enrollment, credentialing, and any other activity as it relates to payer interaction.

What Revenue Cycle Management (RCM) contributes to reputed company: Revenue Cycle Management drives the strategies, processes, and technologies that optimize revenue capture, reimbursement, and financial performance across the patient care continuum. Spanning the full patient journey from scheduling through final account resolution, the team leverages operational expertise, analytics, and process improvement to enhance revenue integrity, streamline workflows, and improve financial outcomes. Our revenue cycle professionals' partner with clinical, operational, and financial stakeholders to deliver efficient, scalable solutions that support organizational growth and exceptional patient experiences.

The Advisor, Revenue Cycle Management serves as a strategic partner responsible for optimizing revenue cycle systems, reimbursement methodologies, and data governance practices. Through cross-functional collaboration, analytics, and continuous improvement initiatives, this role drives revenue integrity, operational performance, and informed business decision-making while supporting the organization's financial and growth objectives.

Responsibilities

Provide consultative oversight of revenue cycle practice management system configuration, optimization, governance, and ongoing operational effectiveness.

Serve as the primary subject matter expert for revenue cycle systems, providing consultative guidance, issue resolution, and support to stakeholders while promoting operational efficiency and data integrity.

Lead complex system configuration, troubleshooting, and enhancement activities; collaborate with IT and vendor partners to resolve issues, implement system improvements, and perform routine audits to ensure data accuracy and compliance.

Continuously evaluate revenue cycle system performance and business processes, utilizing analytics and stakeholder feedback to identify opportunities for workflow optimization, operational efficiencies, enhanced data integrity, and improved financial outcomes.

Oversee the governance and optimization of insurance plan configurations within the revenue cycle platform, ensuring alignment with payer contracts, reimbursement methodologies, revenue integrity objectives, and organizational reporting requirements.

Partner with Revenue Cycle, Finance, and Operational stakeholders to establish and maintain contract group structures, ensuring accurate revenue attribution, contract compliance, and meaningful financial reporting across provider, entity, and payer relationships.

Analyze payer, reimbursement, and operational performance data to identify opportunities for revenue enhancement, process improvement, reimbursement optimization, and increased revenue cycle effectiveness.

Provide oversight of fee schedule administration, ensuring accurate system configuration, reimbursement alignment, and support for revenue optimization and financial reporting initiatives.

Manage the review, implementation, and validation of coding updates in collaboration with vendor partners, ensuring timely configuration of CPT, HCPCS, and ICD-10 changes to support accurate reimbursement and regulatory compliance.

Own provider and location master data governance within the revenue cycle platform, driving standardization, data integrity, and process improvements that support operational scalability, reimbursement accuracy, and organizational growth.

Collaborate with Operations, Credentialing, and other key stakeholders to ensure provider and location records remain accurate, current, and synchronized across revenue cycle systems, supporting operational readiness, compliance, and financial performance.

Qualifications

8-12 years of experience, preferred

Bachelor's degree in related field, or equivalent work experience, preferred

At least five (5) years of experience in a revenue cycle management or related field preferred

Strong understanding of medical coding, billing practices, and revenue cycle processes

Proficiency in revenue cycle management software and MS Office Suite

Excellent analytical, organ .