Job description:
We are looking for an experienced Assistant Manager – Healthcare Revenue Cycle Management (RCM) to lead front-end operations focused on pre-clearance and prior authorization workflows. This role is responsible for team leadership, operational oversight, KPI management, and ensuring compliance with payer and regulatory standards while driving performance improvements.
Key Responsibilities:
Team Leadership & Management
- Supervise, coach, and develop a team of Patient Access Representatives and Specialists
- Set clear performance expectations and conduct regular performance reviews and feedback sessions
- Manage staffing, scheduling, and workload distribution to meet SLAs
- Foster a culture of accountability, collaboration, and continuous improvement
Operational Oversight
- Oversee daily pre-clearance and prior authorization activities
- Ensure timely completion of authorizations prior to scheduled services
- Verify insurance eligibility, benefits, and coverage accuracy
- Monitor work queues and manage backlogs and turnaround times
- Serve as escalation point for complex and urgent cases
Quality & Compliance Management
- Ensure adherence to payer requirements, HIPAA, and internal policies
- Conduct regular quality audits for accuracy and completeness
- Implement corrective actions to address variances and improve compliance
Performance Monitoring & Reporting
- Track and manage key KPIs, including:
- Authorization Secure Rate & Days Out
- First-pass Approval Rate
- Authorization-Related Denial Rate
- Productivity & Accuracy Metrics
- Prepare and present performance reports and insights to leadership
- Drive team accountability to meet departmental targets
Training & Staff Development
- Identify training needs and support continuous learning initiatives
- Lead onboarding for new hires and provide ongoing coaching
- Partner with SMEs to ensure consistent knowledge sharing
Process Improvement & Optimization
- Identify workflow inefficiencies and lead initiatives to:
- Improve turnaround time
- Reduce denials
- Support process enhancements, automation opportunities, and system upgrades
- Drive adoption of new tools and technologies
Stakeholder Collaboration
- Coordinate with:
- Doctors offices and clinics for documentation & medical necessity
- Scheduling teams for patient flow optimization
- Billing & revenue cycle teams for denial prevention
- Handle escalations and maintain strong stakeholder relationships
Qualifications:
Education
- High School Diploma (required)
- Associate's or Bachelor's Degree (preferred)
- Preferred backgrounds: Allied medicine, Pharmacy / Bio-Tech, Life Science Graduates, Medical Terminology / Human Anatomy
Certifications
- CRCR (Certified Revenue Cycle Representative) – Preferred
- Internal Certifications (a plus):
- Optum Global RCM Academy
- LPS Core & Process Training
- RCM Enlight: New Manager Program
Experience
- Minimum 3+ years in Front-End Healthcare RCM, including: hospital patient registration department, physician office. setting, healthcare insurance company, revenue cycle vendor, and/or other revenue cycle-related role.
- At least 1.5+ years as Supervisor or Assistant Manager
Skills & Competencies:
Leadership & People Management
- Strong team leadership, coaching, and mentoring skills
- Experience in performance management, conflict resolution, and engagement
- Accountability-driven with strong decision-making ability
Operational & Process Management
- Solid understanding of end-to-end patient access & authorization workflows
- Skilled in SLA management, prioritization, and resource allocation
Performance & Data Management
- Ability to interpret KPIs, dashboards, and operational reports
- Strong data-driven decision-making skills
- Proven capability in driving performance improvements
Quality & Compliance
- Knowledge of audit processes, payer requirements, and compliance standards
- Experience implementing corrective and preventive actions (CAP)
Communication & Stakeholder Management
- Excellent interpersonal and communication skills
- Ability to collaborate across clinical, operational, and billing teams
- Skilled in handling escalations and payer interactions
Training & Workforce Development
- Ability to develop high-performing teams
- Experience in onboarding and upskilling teams
- Promotes a culture of continuous learning
Change Management & Continuous Improvement
- Experience leading process improvement and transformation initiatives
- Adaptable to system, workflow, and policy changes
- Focus on automation, efficiency, and innovation
WHAT WE OFFER
- Market Competitive Pay Levels
- Retirement Plan
- Medical Plan (HMO) from Day 1 of employment
- Dental, Medical, and Optical Reimbursements
- Life and Disability Insurance
- Paid Time-Off Benefits
- Sick Leave Conversion
- Tuition Fee Reimbursement
- Employee Assistance Program (EAP)
- Annual Performance Based Merit Increases
- Employee Recognition
- Training and Staff Development
- Employee Referral Program
- Employee Volunteerism Opportunity
- All Mandatory Statutory Benefits
WHO WE ARE
- Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.
- UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
- We're a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.
- As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.
- Elevate your career with a leading health care company while improving lives.
Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that's dedicated to Caring. Connecting. Growing together.
