Jobs at R1 RCM

Partner with executives and operational teams to assess current-state processes, design future-state workflows, and implement revenue-cycle and coding improvements. Lead process mapping, KPI/SLA monitoring, training, change management, and AI-driven coding optimization to drive adoption and measurable performance improvements.

Design and optimize consulting delivery processes, quantify use case ROI, lead and mentor consultants, develop roadmaps and change management, provide technical/product leadership, monitor KPIs/SLAs, and ensure continuous improvement. Role requires frequent customer engagement and significant travel (50%+).

The role involves delivering business case quantification, optimizing processes, mentoring teams, and ensuring client satisfaction in healthcare revenue management.

Conduct concurrent and retrospective reviews of inpatient records to improve clinical documentation and coding accuracy. Query physicians, assign working DRGs, perform mortality and PSI reviews, educate providers and CDI staff, collaborate with coders and quality teams, and assist onboarding/training of new CDI members.

Design, develop, and maintain Snowflake-backed semantic models and Power BI reports; build SQL queries, functions, and stored procedures; use AI-assisted tooling (Claude, MCP) to accelerate BI development; manage work in Azure DevOps, version control with GitHub; ensure QA, documentation, stakeholder communication, and mentor fellow developers.

Represent healthcare providers in disputes over workers' compensation, motor vehicle accident, third-party liability, and VA claims. Draft complex appeals and correspondence, apply state-specific statutes and lien laws, coordinate with external counsel, train recovery staff, and develop strategic legal and procedural approaches to recover denied claims efficiently.

Review outpatient clinical documentation to accurately assign ICD-10-CM, HCPCS and CPT-4 codes; perform retrospective quality audits; identify and correct coding errors; support reporting, education, and performance improvement; maintain coding guideline knowledge and compliance.

Lead optimization of Patient Access workflows (registration, financial clearance, scheduling, customer service) by translating operations into AI-enabled, automated solutions. Drive performance management, reporting, and cross-functional alignment; refine AI quality frameworks and metrics; coach lead-level staff and support process improvement to improve efficiency and revenue cycle outcomes.

Lead a team building the Entri scheduling and order management platform. Drive architecture, modernize legacy desktop apps into scalable SaaS, design and deliver distributed microservices, mentor engineers, partner with product and cross-functional teams, and resolve complex production issues to improve patient scheduling and coordination.

As an Interface Specialist II, you will develop and optimize automated processes, support integrations, manage projects, and collaborate on process improvements.

Verify and load platform-discovered patient insurance coverage into R1 and client systems to improve billing accuracy and recovery. Manage coverage work queue, research eligibility, coordinate with payers and provider teams, update patient records, follow client SOPs, maintain HIPAA compliance, support reporting/metrics, recommend improvements, and train/liaise between clients and internal teams.

The Physician Advisor reviews denied authorization cases, evaluates documentation, advises on request appropriateness, and engages with payor medical directors, serving as a clinical resource for staff.

As a Senior Product Manager, you will oversee AI analytics product development, prioritize initiatives, communicate with stakeholders, and manage the product roadmap while ensuring timely delivery of features and aligning them with business strategies.

The Forward Deployed Process Consultant will bridge executive strategy with operational execution in healthcare, focusing on process optimization and stakeholder communication. Responsibilities include translating business requirements, collaborating on solutions, and monitoring performance metrics.

Lead commercial product enablement for PhareOS by turning complex AI-native capabilities into clear buyer narratives, defining demo strategy, supporting strategic deals, and building scalable enablement programs and materials across Sales, Product, Client Delivery, and Marketing.

Translate operational requirements into solution designs, process maps, and implementation plans. Conduct current-state assessments, support implementation and stabilization, define KPIs/SLAs, manage stakeholder communications, change management, and risk/issue mitigation while partnering with process engineers and cross-functional teams.

Translate business requirements into implementation artifacts, document current and future-state workflows, and support end-to-end delivery of use cases. Assist with implementation plans, stakeholder communications, training, change management, go-live stabilization, KPI/SLA tracking, and post-implementation reviews. Maintain trackers, issue logs, and support continuous improvement. Role may require extensive travel to client sites.

Analyze denied claims to identify clinical, coding, and process root causes; write clear problem statements; quantify financial impact; partner with coding and revenue cycle teams to recommend and drive corrective actions to reduce preventable denials.

As a Coding Integrity Specialist, you will conduct coding reviews, ensure proper reimbursement, collaborate with teams, and provide feedback on coding accuracy.

The RVP of Sales will drive revenue growth through client acquisition and expansion by executing strategies, forecasting sales, and collaborating with internal teams.