[Hiring] Director, RCM Shared Services @OneOncology

Role Description

The Director, RCM Shared Services (Urology) is responsible for leading strategic and operational initiatives for practice-based revenue cycle management (RCM) teams, third-party RCM vendors, and internal OneOncology stakeholders supporting urology practices. This position drives revenue cycle projects, utilizes analytics to optimize performance, implements best-practice workflows, and leads corporate in-house RCM teams focused on maximizing financial outcomes while maintaining exceptional patient and provider experiences.

• Ensure accurate coding, charge capture, and reimbursement for urology office visits, diagnostic testing, surgical procedures, surgeries, and ancillary services.
• Manage relationships with third-party revenue cycle vendors and global service partners as well as leading a US-based team.
• Oversee revenue cycle processes related to cystoscopy, prostate biopsy, urodynamics, imaging, ultrasound, lithotripsy, vasectomy, catheter management, and other common urologic procedures and surgeries.
• Manage pre-authorization and medical necessity workflows for surgical and procedural services, including hospital and ambulatory surgery center cases.
• Monitor payer reimbursement trends and regulatory changes impacting urology services and develop strategies to mitigate financial risks.
• Partner with management, coding, compliance, and provider leadership to ensure appropriate application of CPT, HCPCS, ICD-10-CM, and modifier usage specific to urology services.
• Oversee denial prevention and appeals processes for specialty-specific procedures, surgical claims, medical necessity denials, and bundled service edits.
• Ensure optimization of ancillary revenue streams, including pathology, laboratory, imaging, dispensing pharmacy, and other practice-based services.
• Collaborate with management, providers, and practice leaders to improve charge capture, documentation quality, and reimbursement outcomes.
• Analyze procedure utilization, reimbursement performance, RVU productivity, denial trends, and net collection metrics to identify opportunities for improvement and report out on these metrics.
• Support implementation and optimization of practice management systems, EMRs, coding edits, and automation tools to improve revenue cycle effectiveness.
• Serve as a subject matter expert regarding urology/surgery reimbursement regulations, payer policies, fee schedules, and revenue cycle best practices.
• Ensure compliance with Medicare, Medicaid, commercial payer, and governmental regulations related to urologic services and physician practice billing.
• Lead revenue cycle readiness and integration efforts for acquisitions, new providers, service line expansions, and newly implemented ancillary services and any assigned lines of business.
• Monitor vendor performance using established KPIs, SLAs, and operational metrics.
• Collaborate with RCM team to improve reimbursement, collections, denial management, and workflow efficiency.
• Serve as the primary contact for division RCM communications, issue resolution, and performance reviews actively collaborating with management on identified issues.
• Ensure vendor compliance with contractual requirements, organizational policies, and regulatory standards.

Qualifications

• 5+ years of relevant healthcare and RCM leadership experience.
• Bachelor’s degree or equivalent experience required.
• Experience managing third-party revenue cycle vendors or outsourced RCM services preferred.
• Contract management and vendor oversight experience preferred.
• Coding certification preferred.
• Strong background in managed care payer market.
• Urology experience required.
• Strong verbal and written communication skills required.
• Must be detail oriented and organized.
• Strong Microsoft Office skills required, including Excel and PowerPoint.
• High integrity, including maintenance of confidential information.
• Ability to work a flexible schedule based on business need, including some evenings and weekends.