Role Overview
We are seeking a highly organized and detail-oriented Revenue Cycle Manager who thrives in high-volume healthcare environments and is motivated by the opportunity to secure the financial sustainability of essential reproductive health care.
In this role, you will partner with clinical, finance, and operations teams, ensuring the seamless execution of the full claim lifecycle and maximizing net patient service revenue. You will own the workflows, clearinghouse tools, and EHR configurations that help the billing office operate effectively. You will translate financial strategy into action through clear SOPs, rigorous denial management, and direct oversight of two Billing Specialists, guiding their daily productivity and professional development.
The ideal candidate is comfortable working in the weeds of complex billing rules, skilled in revenue analytics, and passionate about building scalable financial workflows that capture earned revenue with greater precision and speed. You excel at spotting revenue gaps, creating structure in billing workflows, and problem solving trends in denials and rejections.
Why This Role Matters
This isn’t a standard RCM role: the financial frameworks you build and maintain directly sustain patient access to safe, timely, and compassionate care. In a pivotal moment for reproductive rights, your ability to optimize reimbursement and navigate complex payer landscapes ensures patients get access to the care they need at no or little out of pocket cost. Your work has a tangible impact on the future of digital healthcare access and the stability of reproductive rights in the U.S.
Responsibilities
- Own design and oversight of end-to-end revenue cycle operations, including charge capture, claims submission, denial management, payer follow-up, patient billing, and AR collections
- Monitor and manage key revenue cycle metrics (clean claim rate, AR days, denial rate, write-off rate) and report results to leadership on a monthly cadence
- Develop and document billing and coding protocols in partnership with Clinical, and ensure consistent application across all payer types
- Lead denial prevention and appeals processes, tracking root causes, identifying patterns, and closing systemic gaps
- Own billing compliance and operational readiness for every new insurance plan Hey Jane accepts — this role does not negotiate contracts, but ensures the infrastructure to bill under them is in place before care is delivered
- Partner with Product and Engineering to evaluate RCM and AI tooling, optimize EHR and billing system configuration, including automations, reporting, and integrations
- Support state expansion by operationalizing billing for new Medicaid programs and payer launches
- Identify and resolve operational gaps in the revenue cycle, building scalable processes that reduce manual work and improve accuracy
- Manage a team of 2-3 billing specialists
Qualifications
- 5–7+ years in healthcare revenue cycle or billing operations, with at least 2 years in a management or lead role
- Medi-Cal/Medicaid billing experience strongly preferred; multi-state Medicaid experience a strong plus
- Telehealth, reproductive health, or women's health background strongly preferred
- Fluency in clearinghouse workflows, ERA/EOB reconciliation, and CPT/ICD-10 coding for reproductive and virtual care
- Hands-on experience configuring and managing billing systems and EHRs; comfortable being the internal subject-matter expert
- Analytical mindset with a track record of using data to identify trends, track KPIs, and drive process improvements — not just reporting numbers but acting on them
- Strong cross-functional operator: able to work with Clinical, BD, Finance, Product, and Clinical Operations without needing a go-between
- Excellent written and verbal communication skills; able to translate billing complexity into clear escalations, documentation, and leadership updates
- Thrives in fast-paced, ambiguous environments; adaptable, resourceful, and solutions-oriented
- Passion for Hey Jane’s mission and a commitment to expanding access to essential healthcare
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