Sr. Director, Revenue Operations

Responsibilities

• Revenue Cycle Management
• Design, implement, and continuously improve end-to-end revenue cycle processes from service delivery through final payment collection.
• Lead monthly cadence of revenue performance working sessions with Finance and Operations leaders to ensure alignment and tracking with budget/forecast and determine if any adjustments to projections
• Participate and serve as key stakeholder for revenue forecasting process (3+9, 6+6, 9+3) and annual budget builds.
• Monitor key performance indicators (KPIs) including days in accounts receivable (AR), denial rates, clean claim rates, and cash collections.
• Lead cross-functional teams to resolve systemic billing, coding, and collections issues that impact revenue performance.
• Oversee the tracking and management of claim inventory across all clients and solutions to ensure accurate alignment between services delivered and value realized
• Establish controls and processes to reconcile inventory records with billing and revenue data, minimizing discrepancies and revenue leakage.
• Optimize revenue cycle speed and performance - reducing time to value from identified savings to revenue realization
• Partner with operations and business segment leaders to maintain visibility into inventory levels, utilization rates, and cost implications.
• Monitor inventory-related variances and work with business partners to implement corrective action plans to address gaps between inventory and financial records.
• Revenue Conversion
• Drive strategies to convert authorized or earned revenue into cash receipts at maximum efficiency.
• Identify and eliminate bottlenecks in the order-to-cash cycle that delay revenue realization.
• Partner with operations to align service delivery timelines with billing milestones.
• Track and report on conversion rates by payer, service line, and geography; implement action plans to close performance gaps.
• Revenue Integrity
• Establish and govern a robust revenue integrity program to ensure accuracy, completeness, and compliance of all billings
• Conduct regular audits of coding, documentation, and processes to identify risk exposure and opportunities for revenue recovery.
• Partner with compliance and legal teams to ensure adherence to federal and state regulations, including CMS guidelines, HIPAA, and applicable fraud and abuse laws.
• Implement proactive monitoring tools and controls to prevent underpayments, overbilling, and revenue leakage.
• Invoicing
• Oversee the timely and accurate generation, delivery, and reconciliation of customer and payer invoices.
• Ensure invoicing systems and workflows are aligned with contractual terms, regulatory requirements, and internal controls.
• Manage dispute resolution processes for invoice discrepancies, driving prompt and equitable resolution.
• Evaluate and implement technology solutions to streamline invoicing workflows and reduce manual processing errors.
• Create a best-in-class client experience as it relates to the revenue conversion and invoicing process.
• Contract Management and Performance
• Serve as central lead and point of contact for all CPS business segments, as it pertains to contracting (new clients, existing client expansion, renewals, etc.) - with focus on Statement of Work (SOW)
• Maintain a centralized contract repository and ensure key terms, rates, and obligations are accurately reflected in billing and operational systems.
• Analy

Benefits

Additional Information

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs. The Senior Director of Revenue Operations and Client Performance serves as a senior leader responsible for the overall revenue cycle performance and value recognition for Machinify's CPS business. This role oversees revenue conversion and integrity, billing / invoicing, contract management, pricing and performance (SOW) - ensuring operational excellence, best practices, financial accuracy, and compliance across all CPS revenue-generating functions and business segments. The Senior Director partners closely with Finance, Legal, Growth/Sales, Client Success, and Operations teams to optimize revenue capture, minimize revenue leakage, and uphold the highest standards of billing integrity and compliance across all health plan / payer client engagements. Additionally, this role is responsible for managing and tracking all contractual obligations (SLAs) and to ensure a best-in-class client experience as it relates to value realization for our clients.

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