Vice President, Revenue Cycle Management
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Job Description
Senior executive leading strategic direction and operational priorities in revenue cycle management for Brightline, specializing in pediatric mental health services.
Responsibilities:
- Develop and own the multi-year revenue cycle strategy aligned to the corporate strategic plan, translating it into operational priorities, investment decisions, and measurable performance outcomes across the full revenue cycle continuum.
- Manage and develop a team of Directors spanning Payor Enrollment, Licensing & Credentialing, Medical Billing, Coding, Accounts Receivable, Denials Management, and Revenue Integrity — setting direction, holding leaders accountable to outcomes, and building a high-performing, scalable organization.
- Provide executive leadership across all revenue cycle functions — including charge capture, coding, billing, claims submission, accounts receivable, and collections — driving automation, technology adoption, and continuous performance improvement against KPIs including net collection rate, DAR, clean claim rate, and denial rate.
- Develop and lead change management and risk mitigation strategies for revenue cycle operations, including proactive planning for regulatory changes, payor policy shifts, technology transitions, and organizational growth or restructuring.
- Maintain executive accountability for payor enrollment and provider credentialing functions, ensuring providers are enrolled and credentialed accurately, compliantly, and within timelines that protect the organization’s ability to bill and collect — including proactive planning for new market expansions and acquisitions.
- Set strategic direction for denials prevention and revenue integrity, driving a proactive, analytics-based approach to root cause analysis and systemic issue resolution, in partnership with Compliance and Legal.
- Represent the organization externally with payor executives, at industry forums, and in high-stakes contract negotiations — serving as the senior revenue cycle voice and relationship holder at the executive level.
- Lead revenue cycle technology strategy, sponsoring investment in practice management systems, coding tools, credentialing platforms, AI-assisted tools, and analytics capabilities that provide real-time executive visibility into revenue cycle performance.
Requirements:
- 10+ years of progressive revenue cycle management experience in a healthcare services setting, with at least 5 years in a senior leadership role managing Directors or equivalent
- Demonstrated experience developing and executing revenue cycle strategy, improving net collection rates, reducing DAR, and leading organizations through transformation
- Experience overseeing payor enrollment and provider credentialing functions at scale; multi-site, multi-specialty, or multi-state experience preferred
- Deep expertise in Medicare, Medicaid, and commercial payor billing rules, credentialing standards, and enrollment processes
- Strong knowledge of ICD-10, CPT, and HCPCS coding principles and compliance requirements
- Proven ability to represent an organization externally with payors, in contract negotiations, or at an industry level
- Experience leading change management and enterprise risk mitigation in a complex, high-growth, or highly regulated environment
- Strong executive presence with the ability to present complex financial and operational information to senior leadership and the Board
- Proficiency with practice management and EHR platforms; enterprise credentialing systems (e.g., Cactus, Verity, MD-Staff) a plus
- Bachelor’s degree in Business, Healthcare Administration, Finance, or related field required; Master’s degree (MBA, MHA, or equivalent) strongly preferred
- Preferred certifications: CRCE or CRCP (HFMA/AAHAM), CPC (AAPC), and/or CPCS or CPMSM (NAMSS)
Benefits:
- Medical, Dental, Vision, Long-Term Disability, Life Insurance, Flexible Spending Account, and 401k
- 12 Company Holidays, Holiday Shutdown, Flexible Time Off, Parental Leave
- Health and Wellness Stipend, Home Office Reimbursement and Professional Development Reimbursement
- Stock Options
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