- Location
- Boston, MA
- Department
- Sales
- Seniority
- Director
- Source
- PCRecruiter
Description
Client Summary:
Partner-Facing Revenue Leadership
Required Experience and Qualifications:
Preferred Experience and Qualifications:
- Digital health company redefining remote patient monitoring by combining advanced AI with experienced clinical care teams to deliver ongoing, person-centered care
- Partners with health systems, clinics, and care organizations as a seamless extension of their provider teams with no IT lift or added clinical burden
- Full-service partnership model delivering technology, clinical staffing, integration, and ongoing management with rapid time to value and no capital expenditure
- Demonstrates strong, measurable outcomes across chronic condition management including readmission reduction, blood pressure control, and A1c improvement
- Multiple industry recognitions for innovation and impact in remote care delivery, positioned in the growing remote care and chronic disease management market
Partner-Facing Revenue Leadership
- Serves as the revenue cycle authority in partner-facing conversations — sales pursuits, implementation kickoffs, business reviews, and escalations.
- Translates clinical model into billing reality and builds trust with practice administrators, billing directors, and CFOs without direct authority.
- Identifies and closes revenue leakage through data analysis, workflow audits, and structured business reviews tied to shared KPIs and revenue outcomes.
- Partners with Sales through active pursuits — joining calls, making the revenue case, and building ROI models and reimbursement projections that help close deals.
- Develops sales enablement (payer coverage maps, coding guides, FAQs) and due-diligences prospect billing infrastructure to size implementation complexity.
- Owns the revenue cycle workstream during implementation — workflow design, EHR integration, payer credentialing, and go-live readiness — with playbooks that make setup faster and more consistent.
- Sets go-live billing benchmarks and drives the first 90 days hands-on to catch and correct issues early.
- Maintains deep expertise in RPM reimbursement (CPT 99453, 99454, 99457, 99458) and related CCM and chronic care codes, serving as the internal and external subject-matter expert.
- Stays ahead of CMS rulemaking and payer policy, turning changes into operational guidance before they become problems.
- Owns the full revenue lifecycle — eligibility, authorization, coding, claims, denials, payment posting, and collections — with compliance and audit readiness embedded in workflows.
- Builds scalable enablement systems (KPIs, dashboards, governance) and drives multi-vendor accountability across RCM partners and clearinghouses.
- Builds AI into the core of the revenue cycle — agent-assisted coding, denial prediction, and eligibility and authorization automation — to raise accuracy and speed by pairing the team’s expertise with automation.
- Brings the current team along — introducing AI and new workflows in a way that builds on their experience and earns their trust.
- Pilots and scales new tools and workflows that take the revenue performance to a new level, turning emerging capability into operational advantage.
- Sets the standard for AI-enabled revenue cycle that partners and the market can learn from, with the judgment to verify output before relying on it.
- Aligns Revenue, Care Operations, Implementation Design, Product, and Finance around measurable revenue outcomes, translating portfolio insight into product and system improvements.
- Partners with and develops the existing revenue cycle team, building on its strengths and growing it into a high-performing revenue enablement function as the company scales.
Required Experience and Qualifications:
- 7+ years of progressive revenue cycle leadership, including building or transforming a rev cycle team — elevating the function, not just running it.
- Deep expertise in CMS regulations and payer reimbursement mechanics, with the ability to translate policy change into operational action.
- Demonstrated ability to influence external stakeholders — practice administrators, billing directors, health system leadership — without direct authority.
- Strong command of benefits verification and benefit investigations, including teaching partner practices to do it consistently.
- Track record working alongside or embedded with a Sales team, plus experience building or modernizing billing workflows in new or scaling environments.
- Strong analytical rigor — can build a reimbursement projection, read a denial trend, and find root cause — and translates complex policy into plain language; credible with a CFO and in a billing workflow alike.
- An AI innovator — fluent in applying AI to coding, denial prediction, and workflow automation, and driven to rebuild revenue cycle around it rather than bolt it on, with the execution discipline to deliver in ambiguous, fast-moving settings.
Preferred Experience and Qualifications:
- Direct experience with RPM, CCM, PCM, APCM, or tech-enabled care services billing — fluency in the remote care CPT landscape is a strong differentiator.
- A tech-enabled RPM/CCM or chronic care company where billing is a shared service between vendor and provider practice — the model this company runs.
- A health IT or RCM technology company in an implementation or client-success leadership role, standing up billing workflows across diverse provider environments.
- An MSO, physician-enablement, or value-based care platform — or rev cycle consulting with client ownership — where revenue cycle runs as a service for practices.
Skills
EHRCompliance
