EverHealth - Revenue Cycle Management (RCM) Manager ( Remote, US)

The RCM Manager provides strategic leadership for the Claims Management Specialist team by establishing priorities, driving performance, and ensuring the team delivers actionable insights that improve client financial outcomes. While Claims Management Specialists are responsible for investigating claims, identifying root causes, and recommending solutions, the RCM Manager is accountable for working with leadership on the strategic direction, removing operational barriers, aligning resources, and ensuring recommendations are executed to achieve measurable improvements in revenue cycle performance.

Key Responsibilities

Leadership & Team Management

• Lead, mentor, and develop the Claims Management Specialist team.
• Establish team goals, performance expectations, and professional development plans.
• Monitor productivity, quality, and service levels to ensure operational excellence.
• Foster a culture of accountability, collaboration, continuous learning, and data-driven decision making.
• Conduct performance reviews, coaching sessions, and career development planning.

Strategic Leadership & Accountability

• Establish the strategic vision and priorities for the Claims Management Specialist team in alignment with organizational and client objectives.
• Own revenue cycle performance by ensuring the team focuses on the highest-impact opportunities for revenue recovery and operational improvement.
• Translate analytical findings into actionable business strategies and operational initiatives.
• Prioritize work based on client health, financial impact, payer trends, and organizational goals.
• Remove barriers that prevent successful execution of team recommendations.
• Hold the team accountable for delivering measurable improvements in key revenue cycle metrics while empowering specialists to determine the most effective analytical approach and claim resolution strategies.
• Serve as the primary escalation point for complex reimbursement issues, systemic payer challenges, and cross-functional operational concerns.
• Balance day-to-day operational priorities with long-term strategic initiatives to improve scalability, efficiency, and client outcomes.

Revenue Cycle Strategy & Performance

• Develop and execute strategies to improve revenue cycle performance across assigned client portfolios.
• Monitor organizational and client-level performance against established KPIs.
• Identify trends impacting reimbursement and implement corrective action plans.
• Provide strategic recommendations to senior leadership regarding revenue cycle optimization.
• Drive initiatives that improve cash flow, reduce aging accounts receivable, and increase reimbursement.

Claims Management Oversight

Provide oversight and direction for the Claims Management Specialist team responsible for:

• Complex claims resolution
• Root cause analysis of denied and unpaid claims
• Payer trend analysis
• Practice workflow analysis
• Revenue recovery opportunities
• Escalation of systemic reimbursement issues

Ensure recommendations developed by the team result in measurable operational improvements.

Denial Management & Revenue Integrity

• Oversee organizational denial management strategy.
• Review denial trends and identify systemic opportunities for improvement.
• Partner with operational leaders to implement denial prevention initiatives.
• Ensure timely escalation of payer issues and reimbursement challenges.
• Monitor effectiveness of corrective action plans.

Client Health & Operational Partnership

• Partner with Service Managers to improve client financial performance and overall client health.
• Participate in client business reviews and operational performance meetings.
• Support initiatives that improve client retention and revenue optimization.
• Provide executive-level reporting and recommendations on revenue cycle performance.

BPO Oversight & Operational Excellence

• Provide leadership for BPO performance related to revenue cycle functions.
• Ensure consistent claim resolution practices across internal and outsourced teams.

Analytics & Reporting

Develop and monitor dashboards and performance reporting for key revenue cycle metrics, including:

• Accounts Receivable >90 Days
• Days Revenue Outstanding (DRO)
• Denial Rate
• Clean Claim Rate
• Net Collection Rate
• Cash Collections
• Aging A/R
• Appeal Success Rate
• Payer Performance Trends
• Client Health (RAG Status)

Use analytics to prioritize improvement initiatives and communicate performance to leadership.

Process Improvement & Innovation

• Lead continuous improvement initiatives across revenue cycle operations.
• Identify workflow inefficiencies and implement scalable solutions.
• Collaborate with Technology and Product teams to enhance reporting and automation.
• Standardize best practices across clients and operational teams.
• Support implementation of new revenue cycle technologies and process enhancements.

Compliance & Industry Knowledge

• Ensure compliance with payer guidelines, HIPAA, CMS regulations, and organizational policies.
• Maintain current knowledge of reimbursement methodologies and industry trends.
• Support audit readiness and quality assurance initiatives.

Skills and Experience needed for success in this role: 

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field (or equivalent experience).
• 7+ years of Revenue Cycle Management experience.
• 3+ years of leadership experience managing revenue cycle or accounts receivable teams.
• Deep expertise in:
  • Claims management
  • Denial management
  • Accounts receivable
  • Revenue cycle analytics
  • Payer reimbursement methodologies
  • Healthcare operations
• Strong analytical, reporting, and problem-solving skills.
• Experience leading cross-functional initiatives and influencing stakeholders.

Preferred

• Experience working with outsourced (BPO) revenue cycle operations.
• Experience supporting multi-client healthcare organizations.
• Experience with healthcare analytics platforms, BI reporting, and revenue cycle dashboards.

Where: 
The EverCommerce team is distributed globally, with teams in the U.S., Canada, the U.K., Jordan, New Zealand, and Australia. With a widely distributed team, we are used to working remotely across different time zones. This role can be based anywhere in the United States – if you’re close to one of our offices, we can set you up in-office or you can work 100% remotely. Please note that you must be eligible to work without sponsorship to qualify for this position, and this role may require travel to our Corporate Headquarters in Denver, Colorado, or to other office locations around North America.