[Hiring] Director of Insurance Operations @Circle Medical Technologies Inc

Role Description

The Director of Insurance Operations is a newly created, leadership role responsible for the full financial lifecycle of Circle Medical’s revenue, spanning both payor-facing reimbursement and self-pay appointments:

• Own end-to-end accountability for all clinical revenue.
• Negotiate and manage payor contracts.
• Lead the RCM organization responsible for coding integrity, claims submission, payment posting, denial management, and both insurance and self-pay collections.

Responsibilities

• Leadership & Strategy
  • Lead the combined Insurance Operations function as a single, accountable unit.
  • Manage and develop the RCM management team and the Manager, Payor Contracting.
  • Partner with Operations, Finance, Legal/Compliance, Product, and executive leadership to define revenue strategy.
  • Ensure connection between contract terms and collectability.
• Revenue Cycle Operations
  • Own the end-to-end revenue cycle function, ensuring operational efficiency and compliance.
  • Oversee daily RCM operations for a high-volume, multi-state telehealth practice.
  • Own key workflows and process maps for claim submission, follow-up, denials, and appeals.
  • Collaborate with Product and Engineering teams to improve automation and billing system integrations.
• Payor Contracting & Relations
  • Negotiate and execute contracts with healthcare payors, ensuring favorable terms.
  • Analyze clinical outcomes to develop compelling value propositions for payors.
  • Monitor payor performance against KPIs and address discrepancies.
  • Maintain strategic relationships with payor organizations.
• Analytics & Performance Management
  • Enhance, track, and report on KPIs across RCM and payor contracting.
  • Partner with Business Intelligence to develop automated dashboards.
  • Drive data-driven performance reviews to identify trends and opportunities for improvement.
• Cross-Functional Collaboration
  • Serve as the operational liaison between Insurance Operations and other departments.
  • Partner with Credentialing and Provider Enrollment for accurate payor setup.
  • Collaborate with Finance on cash forecasting and revenue recognition.
• Compliance & Continuous Improvement
  • Maintain compliance with payor and state telehealth billing requirements.
  • Lead initiatives to improve claim accuracy and reduce denials.
  • Identify automation and system enhancement opportunities.

Qualifications

• 8+ years of experience in US healthcare operations with increasing responsibility.
• At least 4 years in a leadership role spanning revenue cycle management and/or payor contracting.
• Bachelor’s or Master’s degree in Healthcare Administration, Business, Finance, or a related field.
• Demonstrated experience negotiating payor contracts.
• Deep understanding of healthcare revenue cycle operations.
• Experienced, data-driven operator with a track record of building KPIs and performance management frameworks.
• Strong communication and stakeholder management skills.
• Exceptional leadership skills with the ability to inspire teams.
• Demonstrated ability to thrive in fast-paced, ambiguous environments.

Compensation

Our compensation is market-aligned, performance-led, and designed to ensure internal equity. We review pay regularly, with progression tied to demonstrated impact and expanded scope rather than tenure alone.

• Tier 1 (San Francisco and similar cost markets): $157,520 – $196,900 base salary
• Tier 2 (Chicago and similar cost markets): $137,280 – $171,600 base salary
• Tier 3 (National, all other U.S. locations): $133,600 – $167,000 base salary

Benefits

• Paid Time Off: Flexible vacation, sick leave, and 12 statutory holidays.
• Health & Insurance: Medical, Dental, Vision, Disability, and Life insurance.
• Wellness: Mental health programs and an Employee Assistance Program (EAP).
• Retirement: RRSP/401(k) program with company match.
• Development: Annual reimbursement for eligible training and professional programs.