Program Director

About the Role

This role provides senior leadership and strategic direction for all end‑to‑end revenue cycle operations across our client’s state‑run health facilities. The Program Director will work closely with finance, clinical, IT, and compliance teams to optimize financial performance, ensure regulatory compliance, and improve cash flow. Operating in a fast‑paced, highly regulated healthcare environment, the incumbent will guide a multi‑tiered team of managers and specialists while partnering with state agencies and payer organizations. The impact of this position is measured by reduced claim denials, improved net collections, and a robust, audit‑ready revenue cycle.

Key Responsibilities

• Develop and execute a comprehensive revenue cycle strategy aligned with financial and compliance objectives.
• Lead and mentor a multi‑disciplinary team of managers, coders, billers, and collections staff across all facilities.
• Monitor and improve key performance indicators such as A/R days, denial rates, clean claim percentages, and net collection ratios.
• Ensure compliance with CMS, HIPAA, state regulations, and payer policies, maintaining audit readiness at all times.
• Oversee Medicaid, Medicaid Managed Care, Medicare, and commercial payer billing processes, addressing complex reimbursement issues.
• Drive technology optimization within Epic revenue cycle modules (Prelude, Cadence, Resolute HB/PB) and implement analytics, automation, and reporting solutions.
• Collaborate with senior leadership, finance, clinical operations, IT, and external payer organizations to align operational goals.
• Prepare and present executive‑level financial and operational reports to senior stakeholders.
• Lead continuous improvement initiatives, standardizing processes across behavioral health, psychiatric care, and developmental disability services.

Required Skills & Experience

• Minimum 8‑10 years of progressive experience in healthcare revenue cycle management, including patient access, HIM/coding, billing, accounts receivable, and collections.
• Demonstrated expertise in Medicaid, Medicare, and commercial payer reimbursement models.
• Proven track record of leading large, enterprise‑wide revenue cycle teams and managing multi‑level staff.
• Strong analytical ability to develop, track, and act on KPIs such as A/R days, denial rates, and net collections.
• In‑depth knowledge of CMS regulations, HIPAA, state‑specific rules, and payer contracts.
• Experience establishing internal controls, audit readiness, and compliance frameworks.
• Excellent executive communication skills with the ability to present complex financial and regulatory information clearly.
• Bachelor’s degree in Health Administration, Business, Finance, or related field; Master’s degree or relevant certifications (e.g., RHIT, RHIA, CPC) preferred.

Tools & Technologies

• Epic revenue cycle suite – Prelude, Cadence, Resolute HB/PB for claims processing and billing workflow.
• Data analytics and reporting platforms (e.g., Power BI, Tableau, or similar) for KPI monitoring and financial forecasting.
• Automation tools for claim scrubbing and denial management.
• Standard office productivity software (Microsoft Office, especially Excel for financial modeling).
• Compliance and audit management systems to ensure regulatory adherence.

Work Schedule & Duration

• Contract length: 6 months (Start Date: 10/01/2026 – End Date: 04/01/2027).
• On‑site work at 1915 Health Services Way, Raleigh, NC, with occasional remote collaboration as needed.
• Full‑time schedule, typical business hours with flexibility to address urgent operational issues.

Interview Process

The interview process generally includes an initial screening call, followed by a technical/leadership interview conducted via webcam or in‑person. Successful candidates may also meet with senior finance and operations leaders for a final assessment.

Position Details

• Employment Type: Contract
• Duration: Approximately 12 months (with potential for extension)
• Work Authorization: Must be authorized to work in the United States