The RCM Clinical Operations Manager is responsible for overseeing clinical operations within the revenue cycle management (RCM) process, ensuring that services meet quality, compliance, and efficiency standards. This role involves coordinating clinical workflows, managing teams, and collaborating with stakeholders to optimize operations and achieve organizational goals.
Team Leadership:
- Leads and directs a staff of 5-6 team leaders that will have individual teams consisting of no more than 20 coders/billing specialists and RCM professionals. Total span of 80-100 FTEs
- Provide training, mentorship, and performance evaluations to ensure team effectiveness.
Operational Oversight:
- Monitor daily clinical operations to ensure accuracy, compliance, and efficiency.
- Develop and implement policies and procedures that align with industry standards and organizational goals.
- Collaborate with billing, coding, and AR teams to resolve clinical documentation issues.
Compliance and Quality Assurance:
- Ensure compliance with regulatory requirements, including HIPAA and other healthcare regulations.
- Conduct audits of clinical documentation to identify gaps and implement corrective actions.
Process Improvement:
- Analyze key performance metrics and identify areas for process improvement.
- Implement strategies to enhance clinical documentation quality and streamline workflows.
Stakeholder Collaboration:
- Work closely with physicians, clinical staff, and clients to address documentation needs.
- Serve as the primary point of contact for clinical operations-related inquiries.
Reporting:
- Prepare regular reports on team performance, audit results, and operational efficiency.
- Present findings and recommendations to senior management.
Qualifications:
- Minimum 5 years of experience in clinical operations, with at least 2 years in a managerial role.
- Certified Professional Coder, Certified Coding Specialist (CCS), Certified Clinical Documentation Specialist (CCDS), or equivalent.
- Education: Nursing or Medical Allied
