Himalayas รีโมท / WFH Kesehatan Full Time

RCM Director

Stella Mental Health

United States USD 145.000 – 165.000 Posted 17/5/2026
Location United States
Salary USD 145.000 – 165.000
Job Type Full Time · Remote
Country Amerika Serikat

Job Description

Full details about the role and requirements

Yukerja Summary

The RCM Director role at Stella Mental Health is curated from Himalayas (category Kesehatan). This role is marked as remote — check timezone and location requirements on the official listing. Yukerja.com is not the employer — applications are handled on the official source site.

About Stella Mental Health

Stella Mental Healthis a leading provider of breakthrough mental health treatments for depression, PTSD, and anxiety. We use cutting-edge modalities, such as ketamine infusions, intranasal esketamine (Spravato), transcranial magnetic stimulation (TMS), and Stellate Ganglion Block (SGB) to help our patients achieve lasting relief. We are a community of compassionate professionals who support our patients and each other throughout their healing journey.

Position Summary

The RCM Director is responsible for the performance of Credentialing, Access, and Billing (RCM), three core functions that enable patient access and drive revenue and cash outcomes.

This leader understands the interdependence of these areas and ensures they operate as a cohesive system. They bring a hands-on, solutions-oriented approach to improving workflows, strengthening payor relationships, and delivering consistent, measurable results.

Top Priorities

  • Build and lead a fully integrated operating model across Credentialing, Access, and Billing
  • Ensure providers are enrolled, contracted, and billable as efficiently as possible
  • Drive consistent, high-quality VOB and prior authorization performance across all markets
  • Improve cash collections, predictability, and revenue cycle performance
  • Strengthen payor relationships and contracting position across geographies
  • Implement scalable SOPs, workflows, and technology (including AI tools)
  • Coordinate with Market Leaders to educate field personnel on their impact on RCM efficiency

(1) Credentialing & Payor Relations

Lead and operate the credentialing and payor engagement function with a focus on accuracy, speed, and strong external relationships.

Key Responsibilities

  • Oversee the full credentialing lifecycle, including enrollments, re-enrollments, re-attestations, monitoring, and maintenance
  • Ensure data integrity, documentation, and record keeping across all credentialing activities
  • Leverage platforms (e.g., Assured) to drive efficiency, visibility, and compliance
  • Maintain a clear understanding of entity structure and its impact on enrollment, billing, and reimbursement
  • Build and manage strong relationships with payor representatives, serving as a primary point of contact and escalation
  • Lead payor contracting efforts, including:
    • Individual, group, and national agreements
    • Rate negotiations and reimbursement optimization
    • Multi-state contracting strategies
  • Identify and resolve barriers to ensure providers are live and billable without delay

(2) Access (Verification of Benefits & Prior Authorizations)

Own the processes that enable patients to access care efficiently, with clear expectations and minimal administrative friction.

Key Responsibilities

  • Drive consistent production and quality of VOB and prior authorizations across all markets and modalities
  • Establish and enforce standard operating procedures, workflows, and performance standards
  • Ensure collection of full patient financial responsibility at time of service (TOS) across all markets, establishing consistent pre-service financial clearance workflows
  • Monitor performance to ensure timely approvals and minimal delays to treatment
  • Build structured processes to challenge and overturn denials, including peer-to-peer workflows
  • Ensure patients receive clear, accurate financial information prior to starting treatment
  • Support teams in removing administrative barriers that impact timely access to care
  • Partner with AI and automation initiatives (e.g., Nanonets) to:
    • Improve throughput and consistency
    • Enhance accuracy and efficiency
    • Continuously refine workflows

(3) Billing & Revenue Cycle Management (RCM)

Provide leadership and accountability for the full revenue cycle, with a focus on performance, discipline, and cash outcomes.

Key Responsibilities

  • Own the end-to-end revenue cycle, including charge capture, coding, claims submission, denial management, and collections
  • Drive team productivity and accountability across internal and external billing resources
  • Monitor and improve key metrics, including:
    • Cash collections
    • Days in AR
    • Denial rates and recovery
    • Clean claim rates
    • Monitoring and pursuit of underpayments
  • Identify breakdowns in performance and address root causes across credentialing, access, and billing workflows
  • Implement billing optimization strategies, including coding accuracy and “incident-to” billing where appropriate
  • Oversee the use of third-party vendors and partners, ensuring performance expectations are met
  • Partner with Finance to ensure alignment on cash performance, forecasting, and budget expectations
  • Leverage AI tools and automation to improve efficiency and scalability

Cross-Functional Leadership

  • Align Credentialing, Access, and Billing into a single, cohesive operating model
  • Establish clear KPIs, reporting, and operating cadence across all functions
  • Serve as the internal subject matter expert and escalation point for payor, access, and RCM challenges
  • Partner with Clinical, Operations, and Finance teams to ensure alignment from intake through reimbursement
  • Build and lead teams with a focus on accountability, consistency, and continuous improvement

Qualifications & Experience

  • Bachelor’s degree in Healthcare Administration, Business, or related field
  • 7+ years of leadership experience across credentialing, access (VOB/PA), and/or revenue cycle management
  • Deep understanding of multi-state payor environments, including Medicare, Medicaid, and commercial plans
  • Proven experience in payor contracting and rate negotiation
  • Strong command of end-to-end reve

Disclaimer: Yukerja.com is a job aggregator, not an employer. This listing is aggregated from Himalayas. Applications are processed on the official company or source site. We are not responsible for listing accuracy.

Tips for Applying to RCM Director

  1. Read the full description and ensure your skills match before applying to Stella Mental Health.
  2. Tailor your CV and cover letter to keywords in the job description — especially for Kesehatan roles.
  3. Click Apply Now to go to Himalayas. The hiring process is entirely on the source site.
  4. Prepare an updated portfolio or LinkedIn profile if required during screening.
  5. Beware of payment requests — legitimate jobs do not charge application fees.

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