# Senior Revenue Cycle Strategy and Operations Manager

**Company**: Pomelo Care
**Location**: United States
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $135,000-$150,000
**Category**: Finance
**Industry**: Healthcare

**Apply**: https://job-boards.greenhouse.io/pomelocare/jobs/6174154004?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_1667ad98-3a1

## Description

## Job Overview

As the Senior Revenue Cycle Strategy and Operations Manager, you will serve as a trusted strategic partner to enable sustainable growth and high-quality patient care through rigorous financial stewardship, data-driven insights, and operational excellence.

## Responsibilities

### Strategic Pricing, Growth & Sales Strategy (35%)

- Design, evaluate, and implement competitive pricing strategies in partnership with the Finance team.

- Lead complex coding discussions to establish viable hybrid FFS/PEMPM models or codes that optimize commercial agreements to maximize customer lifetime value.

- Lead the RCM onboarding process for new B2B clients and newly launched, complex lines of business.

- Map out, document, and implement billing workflows that bridge cross-functional gaps between Sales, Customer Success, and Product.

- Act as the dedicated tier for high-level operational escalations, streamlining processes so critical issues are resolved efficiently.

### Tech Team Collaboration & Tech Stack Optimization (25%)

- Partner closely with the internal tech team to continuously build, refine, and manage the proprietary RCM tech stack.

- Ensure tech integrations allow for efficient scaling, top-tier quality, easy audits, and minimized transaction costs.

- Serve as the strategic super-user across the multi-system tech stack to guarantee seamless data integrity.

### Research, Analysis & Systems Adaptation (20%)

- Proactively research broader healthcare industry shifts, plan benefit changes, and regulatory updates to adapt systems ahead of market changes.

- Analyze the financial impact of shifting payer rules and benefit structures, communicating findings to leadership.

- Utilize data tools like Metabase to monitor revenue cycle health, track performance metrics, and pinpoint systemic denial trends.

- Build, maintain, and manipulate advanced models to audit billing data, reconcile payments, and track client implementation milestones.

### Operational Quality & Denial Strategy (20%)

- Establish quality metrics, audit guidelines, and standard operating procedures to ensure operational rigor across all billing workflows.

- Take ultimate ownership of denial management, identifying operational root causes to proactively prevent future rejections.

- Monitor and optimize daily core RCM execution, including claim submission, clearinghouse error resolution, and payment posting.

## Requirements

- 5–7 years of healthcare revenue cycle experience, ideally within a healthcare startup or digital health company.

- Proven ability to partner with Finance to design pricing structures and collaborate with Product/Tech to build scalable operational tools.

- Deep understanding of commercial and Medicaid insurance billing, claim formats, and denial resolution.

- Advanced proficiency in Google Sheets/Excel, with experience writing basic SQL or using BI tools like Metabase, Tableau, or Looker.

## Benefits and Perks

- Comprehensive Health, Dental, and Vision coverage for employees and their families.

- High deductible Health Plans with Health Savings Account (HSA) options.

- Flexible Spending Account (FSA).

- Equity grant participation.

- 401(k) program.

- Competitive vacation policy.

- 16 weeks paid parental leave.

- Fully remote work flexibility within the US.

## Compensation

The expected base salary range offered for this role is $135,000-$150,000. This role is also eligible for an annual discretionary bonus and equity.

## Skills

### Required
- healthcare revenue cycle
- financial planning
- data analysis
- operational management

### Nice to have
- SQL
- BI tools like Metabase
- Google Sheets/Excel
- coding expertise

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Source: [Apply at job-boards.greenhouse.io](https://job-boards.greenhouse.io/pomelocare/jobs/6174154004?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)