The Revenue Cycle Program Manager partners closely with the Revenue Cycle Operations Manager to lead the strategic development, implementation, and oversight of Central Health’s service lines and revenue cycle programs. This role is responsible for establishing and enforcing operational protocols and performance standards, as well as directing, evaluating, and providing actionable feedback to professional-level staff and key stakeholders involved in revenue cycle operations. As part of the Revenue Cycle leadership team, the Program Manager collaborates with Clinical and Healthcare Delivery Operations teams and EHR analysts to ensure compliance with third-party regulatory requirements and optimize system functionality.

This hybrid position offers flexibility to work both on-site at a Central Health location and remotely from an approved off-site location, based on business needs.

Essential Functions
Strategic Planning & Development
- Collaborates with the Revenue Cycle Operations Manager or higher leadership in the development, growth, and daily operational management of Central Health’s healthcare delivery service lines and programs, ensuring alignment with internal standards and third-party payer requirements.
- From a Revenue Cycle perspective leads the formulation, implementation, and expansion of healthcare delivery service lines and programs in partnership with the Revenue Cycle Operations Manager or higher leadership.
- Assists in the development of key performance metrics and corrective action plans to drive operational excellence.
- Continuously evaluates and refines service lines, programs, and operational strategies to meet industry best practices within healthcare delivery systems.

Operational Oversight
- Oversees the adoption and integration of newly developed workflows into Central Health’s Revenue Cycle processes.
- Monitors, evaluates and assists with the revenue cycle work queues to ensure efficient day-to-day operations.
- Organizes revenue cycle meetings, manages project timelines, and supports cross-functional initiatives to achieve departmental objectives.
- Facilitates coordination between departments such as Finance, Compliance, Providers and Patient Access to streamline processes and promote consistency.

Compliance & Regulatory
- Maintains current knowledge of regulatory requirements impacting the Revenue Cycle and ensures compliance across all activities.
- Ensures all revenue cycle activities comply with payer regulations, federal and state laws, and organizational compliance standards.

Performance & Financial Management
- Oversees revenue cycle operations across service lines to ensure consistent billing, reimbursement, and financial performance aligned with organizational goals.
- Manages third-party billing requirements and payer relationships to ensure accurate claim submission, reimbursement, and contract compliance.
- Identifies workflow inefficiencies and implements process improvements to enhance accuracy, reduce denials, and strengthen overall revenue performance.

Technology & System Support
- Serves as a Revenue Cycle Builder, responsible for Epic configuration, testing, and training to support efficient and compliant system workflows.

Communication & Stakeholder Engagement
-Develops and implements effective communication strategies to provide Central Health leadership with timely operational, financial, and performance updates.
-Collaborates with internal and external stakeholders to optimize patient experience across Central Health service lines.
-Serves as a tertiary point of contact for Revenue Cycle projects and operational requests within Central Health.

Training & Education
-Designs and delivers training programs for stakeholders and providers on revenue cycle processes, coding standards, and documentation guidelines.
-Ensures training materials are updated to reflect regulatory changes, payer requirements, and organizational policies.
- Provides ongoing education to promote compliance, accuracy, and efficiency in billing and documentation practices.

Knowledge, Skills and Abilities:

- Insurance payers contracts and billing requirements

- Healthcare regulations related to billing

- Revenue Cycle clinic operations

Minimum Education:
- High School Diploma or equivalent (higher degree accepted)

Minimum Experience:

- 7 years years of progressively responsible experience in healthcare revenue cycle operations, billing, or reimbursement required