Senior Revenue Cycle Strategy and Operations Manager
Benefits
16w maternity
16w paternity
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Strategic Pricing, Growth & Sales Strategy:
- Partner with Finance to design competitive pricing strategies.
- Lead hybrid billing architecture for FFS/PEMPM models to maximize client lifetime value.
- Own client onboarding and cross-functional billing workflow integration.
Tech Team Collaboration & Tech Stack Optimization:
- Partner with internal tech team to build and refine proprietary RCM tech stack.
- Ensure scalability, cost control, and data integrity across multi-system platforms.
- Serve as strategic super-user for EHRs, clearinghouses, and internal databases.
Research, Analysis & Systems Adaptation:
- Proactively research healthcare industry shifts and regulatory updates.
- Analyze financial impact of payer rule changes using BI tools like Metabase.
- Build advanced financial models to audit billing data and track performance.
Operational Quality & Denial Strategy:
- Establish quality metrics, audit guidelines, and SOPs for billing workflows.
- Take ownership of denial management and identify root causes to prevent future rejections.
- Monitor daily RCM execution including claim submission and payment posting.
Pomelo Care
Pomelo Care is the leading virtual medical practice for women and children, providing proactive, 24/7 clinical care across pregnancy, postpartum, pediatrics, menopause, and perimenopause. The team includes clinicians, technologists, operators, and problem-solvers working together to make high-quality care more accessible for families nationwide.