Director - RCM

The Director of RCM is responsible for the direction and leadership of operational, financial, programmatic, educational, and workforce management for Professional Coding. This includes establishing, meeting, and continuously monitoring the goals and objectives while maintaining alignment with the strategic goals and objectives for Calpion Inc. While the range of duties and responsibilities is broad and varied, the position includes directing the day-to-day operations, budgeting, financial management, and human resource management. The Director works closely with a variety of stakeholders, coordinating the activities of Professional Coding across the enterprise.

Key Responsibilities

• Review performance achievements and targets regularly with AGM/ OM/ and provide strategic direction to improve service delivery
• Identify and resolve problem situations as a final point of escalation
• Improve customer satisfaction by providing better customer experience
• Ensure Operations teams consistently meet predetermined metrics to achieve business objectives and customer SLAs
• Ensure contingency plans are in place for all services, including business recovery/Continuity plans
• Managing operations, including the performance of the team attrition, to minimize any negative impact on the process
• Make sure newly transitioned projects are coordinated with the CSM training provided to the teams when required
• Review client/ internal reports and responsible for completing process-related deliverables as per client requirement
• Continually improve the processes
• Leverage and adopt technology to improve performance and streamline the processes
• Manage the processes within the set Gross/Net Margin goal (Manage the P & L)
• Create a Center of Excellence in the key areas
• Review KRAs with the team and manage the performance of the team members.
• Work with the team on the career path for the team members
• Identifying and implementing ways to build better team effectiveness by encouraging a healthy environment for the team
• Work on the capacity planning/ resource planning vs. forecasted workload with the clients and effective resource utilization
• Coordinate with HRBP on HR-related functions and policies
• Work with Support teams to facilitate smooth operation workflow
• Maintain compliance in the process with HIPAA and ISO standards and adhere to company policies
  

Mandatory Skills

• 14+ years of total work experience in the US Healthcare industry.
• 7+ years in a leadership position (Operations Manager & above) in small/ mid-size RCM operations, proven experience as Operations Manager/ AGM/ similar role, preferably in the provider side of the business
• Experience in managing multiple teams/ locations and executing complex processes
• Good with numbers, metrics, and planning
• Outstanding communication and negotiation skills
• Excellent organizational and leadership ability
• Good problem-solving aptitude and Analytical skills
  

Desired skills

• Experience managing a team size of 500+
• Experience in large-volume billing
  

Talk about our culture and values

At Calpion, were not just a company were a dynamic culture fueled by six core values: Agile, Collaborative, Innovative, Fun, Inclusive, and Passionate. These values drive our every move:

Agile: We thrive on change, adapting swiftly to new challenges.

Collaborative: Together, we achieve greatness through teamwork and diverse perspectives.

Innovative: We push boundaries, constantly exploring new ideas and solutions.

Fun: Laughter and camaraderie make our workplace a joyous one.

Inclusive: Diversity is our strength, ensuring every voice is heard and valued.

Passionate: We approach every task with dedication and enthusiasm.

Join us at Calpion and be part of a culture thats not just about work its about innovation, growth, and making an impact.