RCM Operations & Quality Manager II

Job Description:

The RCM Operations & Quality Manager II is a senior-level role that provides strategic oversight and leadership to RCM global partner teams, managing complex assignments and escalations within the RCM department. The incumbent ensures that all daily, weekly, and monthly tasks are completed efficiently and timely. They spearhead the onboarding and training of new employees and drive performance-based initiatives for clients. Additionally, they oversee the quality of work performed by Specialists, develop and maintain standard operating procedures (SOPs), and serve as a primary RCM subject matter expert within RCM Managed Services and other departments.

• Provide expert guidance to employees and Global Partners on client and company expectations.
• Lead the onboarding and training process, offering continuous feedback on global partner performance.
• Serve as the principal liaison between global partner/vendor team members and management.
• Ensure departmental procedures are thoroughly documented, and SOPs remain accurate and current according to client and industry policies/regulations.
• Resolve escalations that Specialist/Global teams cannot handle, escalating to functional manager when necessary.
• Lead and facilitate discussions with clients regarding performance, trends, and updates.
• Conduct regular performance meetings with departmental employees and global partner vendors.
• Collaborate with management teams to identify potential issues, quantify them, and implement timely remediation plans.
• Ensure service level agreements (SLAs) and productivity requirements are met, focusing on functional area performance, task resolution, and client inquiries.
• Cultivate and maintain positive working relationships with internal and external customers, delivering superior customer service.
• Ensure adherence to best practice setups, policies, and procedures, offering recommendations for improvement.
• Proactively identify and prevent compliance issues.
• Ensure continuity of RCM department services when global partners and/or assigned staff are unavailable.
• Independently develop and implement efficient, effective, and consistent policies, procedures, and process flows for the RCM functional area.
• Lead department and client-specific projects with large scopes, including business plan development and risk assessments.
• Manage and monitor the work quality of Global Partners, ensuring alignment with client protocols and documented procedures.
• Serve as the primary subject matter expert to the broader employee community.
• Perform other duties that support the overall objective of the position.

Education Required:    

• Bachelor's Degree in Finance, Accounting, or Healthcare related discipline.
• Or, any combination of education and experience which would provide the required qualifications for the position.

Experience Required:

• 7+ years of experience in revenue cycle management.
• 3+ years of vendor/partner management and/or client management.

Knowledge, Skills & Abilities:

• Knowledge of: Practice management systems; customer service best practices; Revenue Cycle Management principles, theories, and best practices; laws, regulations, policies, and procedure governing the functional area; Microsoft Office Suit; Windows-based programs.
• Skill in: Effective communication with cross-functional team members, peers, and management; providing customer service to internal and external clients; problem solving, analytical, and critical thinking; working as member of a team; communicating clearly, concisely, and effectively; establishing and maintaining effective working relationships.
• Ability to: Build strong internal and external relationships; work independently with limited direction and/or guidance; maintain confidential information; work in a fast-paced environment; stay organized, prioritize workload, multi-task, and meet deadlines.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.

NextGen Healthcare is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.