[Hiring] Director of Payer Ops and RCM @Alpaca Health

Role Description

Own the revenue engine and company-level outcomes.

• You are accountable for the performance of the entire revenue cycle as a core driver of company growth and cash flow.
• You own collections, denial rate, clean claim rate, and days in A/R.
• Responsible for building a function that delivers predictable, scalable revenue outcomes across markets, payers, and providers.

Build and lead a high-performing RCM organization.

• Recruit, develop, and lead a best-in-class RCM team, setting clear goals, operating cadence, and performance standards.
• Own the strategy and oversight of external vendors, ensuring alignment with internal goals and continuously raising the bar on execution and accountability.

Shift RCM from reactive operations to a proactive growth system.

• Define and execute the strategy to move from billing and follow-up to proactive revenue optimization.
• Architect end-to-end workflows that eliminate revenue leakage at the source—across intake, eligibility, authorization, documentation, and coding—so claims are clean, compliant, and paid quickly.

Own payer performance and rate strategy.

• Lead the strategy for payer performance across the lifecycle—from contracting through reimbursement.
• Partner on payer negotiations and re-negotiations, using data (utilization, outcomes, denial trends, network value) to secure favorable rates and terms.
• Continuously monitor payer behavior, identify underperforming contracts, and drive interventions to improve reimbursement, reduce friction, and maximize long-term payer value.

Act as the executive partner to Product & Engineering.

• Serve as the RCM leader in product development, shaping the roadmap to embed revenue intelligence directly into the platform.
• Drive the development of systems like claim scrubbing, eligibility verification, authorization tracking, and documentation validation, ensuring payer requirements are encoded into workflows by default.

Design the operating system for scale.

• Build the infrastructure required to support rapid expansion across states and payers.
• Standardize where possible, introduce automation aggressively, and create systems that can handle increasing volume and complexity without linear increases in headcount.

Lead with data and continuous improvement.

• Establish a metrics-driven culture with real-time visibility into revenue performance.
• Define the KPIs, dashboards, and operating rhythms that enable the organization to diagnose issues quickly, prioritize effectively, and continuously improve revenue capture and speed to cash.

Qualifications

• 7-10+ years experience in operations with at least 5 years working in commercial payor contracting and revenue cycle operations.
• Experience applying to and executing payor contracts, ideally with experience successfully negotiating higher reimbursement rates with quick contract turnaround times.
• Experience running Revenue Cycle Management and building systems with industry leading claims acceptance rates.
• Previous experience evaluating, onboarding, and managing external vendors/tools.
• Excellent cross-team collaboration, management skills, and attention to detail.
• Strong business acumen with the ability to analyze complex revenue, business, and operational data.
• Experience in the healthcare industry, particularly in pediatric care or related fields.
• We prefer NYC-based candidates (or candidates open to relocation), but are open to remote candidates for this role as well.

Benefits

• Competitive salary.
• Meaningful equity.
• Health benefits.
• Flexible PTO.
• Dinner when working late.