Workstream Project Manager, Revenue Cycle

Key Responsibilities

• Own and manage the end-to-end Revenue Cycle workstream plan, milestones, resources, and integration into the EHR program master schedule.
• Lead revenue cycle design and validation activities across registration, eligibility, authorization, charge capture, coding, claims, remittance, denials, and patient collections.
• Partner with Finance, Revenue Integrity, Patient Financial Services, Clinical Operations, and Information Technology teams to ensure business requirements are accurately reflected in system design and implementation plans.
• Coordinate revenue cycle SMEs, analysts, operational leaders, and build teams to ensure readiness and decision closure throughout the program lifecycle.
• Oversee integrated revenue cycle system configuration, including billing, payer plans, claim edits, work queues, and charge description master (CDM) integration.
• Ensure readiness for all deployment waves by managing revenue protection activities including charge continuity planning, claim hold and release strategies, accounts receivable conversion, financial contingency planning, and post-go-live monitoring.
• Ensure dialysis-specific treatment billing processes are accurately designed and support automated charge reconciliation.
• Manage third-party integrations and readiness activities with clearinghouses, payers, financial systems, and ERP platforms.
• Own the revenue cycle testing strategy, including charge testing, claims testing, payer testing, remittance validation, parallel processing, and end-to-end financial testing.
• Lead revenue protection and cutover planning, including charge capture continuity, claim hold/release processes, accounts receivable conversion, and first billing cycle readiness.
• Monitor post-go-live financial performance metrics including charge lag, clean claim rate, denial rates, unbilled balances, and accounts receivable performance, driving issue resolution where needed.
• Provide ongoing governance, risk management, status reporting, and cross-functional coordination with Clinical, Deployment, Training & Change, Finance, PMO, and ITS teams to protect revenue throughout all deployment waves.

Principal Duties and Responsibilities

• Provide strategic, commercially minded, entrepreneurial management leadership to team managers, domain leads, associates and assistants.
• Oversee revenue cycle design and validation efforts including patient access, registration, eligibility and authorization, charge capture, coding, billing, claims management, remittance processing, denials management, and patient collections.
• Lead project management efforts across Revenue Cycle Design Leads, revenue cycle SMEs, analysts, operational stakeholders, vendor partners, and ITS resources to ensure program objectives, milestones, and deliverables are achieved.
• Ensure project management budgets and schedules are within company requirements with significant organizational responsibility for planning, staffing assignment, budgeting of resources, expense priority management, and recommendation and implementation of changes to current methods.
• Troubleshoot issues related to revenue cycle project management through direct reports and with direct contact of EHR stakeholders including sponsor clients and FMCNA personnel.
• Assist with achieving EHR strategic direction with a focus on creating and delivering value, providing superior customer service, and achieving financial objectives for the managed cost center and for EHR in aggregate.
• Lead teams including internal and external (contractor, subcontractor, vendor) staff assigned to multiple clinical workgroups.
• Ensure good working relationships with and between revenue cycle, finance, and operations leaders and their staff and FMCNA personnel.
• Provide oversight and assist in the recruiting and onboarding of new investigative sites as needed.
• Assist in business development and business operations efforts, client relationship building activities, and other sponsor-facing activities as needed.
• Support the communications and negotiation of contracts related to clinical operations while integrating input from Legal, Compliance, and other entities as needed.
• Direct and control the broad activities of the business unit through interpretation, application, and implementation of company-wide policies and processes appropriate to the functional area.
• Work with Compliance, Legal, and Audit departments as necessary to develop or refine policies and procedures pertaining to EHR.
• Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state, and federal laws and regulations.
• Ensure all employees within the assigned team(s) understand and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state, and federal laws and regulations; establish and maintain effective internal systems and controls to promote compliance.
• Provide leadership, guidance, and coaching for all direct reports to maintain an engaged and productive workforce; partner with Human Resources on employee matters.
• Collaborate with employees in the establishment of clear and concise development plans to ensure succession planning and the advancement of future leaders within the organization.
• Other duties as assigned.

Education

• Required: Bachelor's degree in Finance, Accounting, Business Administration, Health Administration, Health Information Management, or related field.
• Preferred: Master's degree (MBA, MHA, or related discipline).
• Preferred: PMP Certification.
• Preferred: HFMA CRCR, CHFP, AHIMA, AAPC, EHR Certifications, or comparable Revenue Cycle credentials.

Experience and Required Skills

• 10+ years of healthcare revenue cycle, revenue cycle systems, patient financial services, or healthcare finance experience.
• 5+ years of project management or leadership experience.
• Experience leading or supporting at least one large-scale EHR implementation involving billing conversion and production go-live.
• Strong knowledge of the end-to-end healthcare revenue cycle, including registration, eligibility, authorization, charge capture, coding, claims management, remittance processing, denials, and collections.
• Experience with accounts receivable conversion, payer testing, financial reconciliation, and revenue cycle stabilization following system implementations.
• Understanding of Medicare, Medicare Advantage, Medicaid, and Commercial payer reimbursement models.
• Experience working in CMS-regulated healthcare environments and knowledge of applicable reimbursement and compliance requirements.
• Strong analytical skills with revenue cycle performance indicators, including charge lag, clean claim rate, denial rates, first-pass yield, days in accounts receivable, and cost-to-collect metrics.
• Experience managing complex cross-functional initiatives involving Finance, Operations, IT, Clinical, and Vendor organizations.
• Demonstrated ability to manage multiple priorities, budgets, timelines, and stakeholder groups in large-scale transformational programs.
• Excellent verbal and written communication skills, including executive-level presentations and financial risk communication.
• Strong negotiation, influence, problem-solving, and relationship management skills.
• Advanced proficiency with Microsoft Excel, PowerPoint, Project, Smartsheet, Jira, ServiceNow, and reporting/analytics tools.
• Dialysis, nephrology, or chronic disease management revenue cycle experience preferred.
• EHR revenue cycle experience preferred.
• 20% to 30% travel.

The rate of pay for this position will depend on the successful candidate's work location and qualifications, including relevant education, work experience, skills, and competencies.