Director, Revenue Cycle Management

This role is responsible for optimizing and managing the entire revenue lifecycle across our retail brands including billing collections reconciliations and reporting. This role will lead a team accountable for vision insurance plan and billing setup application of insurance benefits in point-of-sale system claims submission payment posting denial management and payer operations. The ideal candidate blends deep managed vision care and RCM expertise with strong analytical ability cross-functional leadership and a passion for improving processes in a fast-paced retail healthcare environment. This leader will partner closely with Finance Accounting IT and Operations teams to achieve their goals.

RCM Strategy & Leadership

• Develop and implement revenue cycle strategies aligned with organizational goals and financial objectives.
• Own the full revenue lifecyclefrom point of sale and billing through payer reimbursement and customer payments.
• Lead and develop high-performing teams overseeing plan setup billing coding claims payment posting and denials.
• Build cross-functional relationships with Store Operations Finance Merchandising IT and the rest of the Managed Care team to ensure end-to-end process integrity.
• Contribute to cross-functional efforts to deliver excellent customer experiences through a consumer-centric mindset.
• Serve as a subject matter expert on billing regulations payer requirements and revenue integrity.

Payor Management

• Strengthen payor relationships to improve reimbursement timelines reduce denials and resolve systemic issues.
• Ensure compliance with coding standards payer policies and state/federal regulations.

Revenue Optimization Process Excellence

• Direct end-to-end revenue cycle operations including claims processing payment posting collections denial management and rebilling.
• Monitor pricing plan setup coding accuracy charge capture and documentation compliance for all products and services.
• Maximize revenue through the accurate and complete capture of all charges.
• Identify root causes of revenue leakage and implement solutions to improve accuracy and speed of reimbursement.
• Oversee reconciliation of revenue accounts and investigate variances between billing and payments.
• Ensures effective and timely denial management and appeals.
• Partner with IT and product teams to enhance POS and RCM technology capabilities.
• Lead continuous improvement efforts creating scalable SOPs and leveraging automation where possible.
• Maintains current knowledge regarding payer requirements and policies ensures system updates are completed accordingly and keeps the team informed and updated regarding changes and requirements.
• Maintain accurate financial documentation for audits and regulatory reporting and compliance.
• Ensures an accurate and timely month-end close process.
• Ensure adherence to GAAP managed care regulations and other payor-specific requirements.
• Implement and monitor internal controls to safeguard revenue processes.

Reporting and Performance Management

• Develop dashboards that provide visibility into billing cycle performance (e.g. coding error rates billing turnaround times collection rates etc.).
• Partner with Finance and Accounting to ensure accurate revenue recognition and forecasting.
• Provide strategic analysis and interpretation of critical revenue cycle data identifying process improvement opportunities and monitoring performance against targets.
• Conduct risk assessments to achieve KPI targets report identified risks to senior management and provide strategic recommendations for mitigation.
• Provide actionable insights to senior leadership through trend analysis and forecasting.
• Develop and implement programs and work plans to increase team accuracy efficiency and effectiveness and ensure delivery of industry-level KPIs.

Team Leadership

• Attract retain and develop top RCM talent.
• Establish clear goals accountability and professional development plans.
• Foster a culture of continuous improvement operational excellence and customer-centricity.

Qualifications :

Work Experience

• 9 years of experience in managed vision care or optical revenue cycle management including leadership of multi-functional RCM teams (required).
• Several years in a management role (required).

Education

• Four-year college degree or equivalent experience. Bachelors degree in Accounting Finance Business Administration or Healthcare Administration (Managed Care) (required).
• Masters Degree MBA (preferred).

Additional Skills

• Demonstrated experience implementing RCM technologies workflow automation and process redesign (required).
• Proven ability in analytical and critical thinking to integrate complex data sources evaluate both qualitative and quantitative information and identify patterns and trends enabling the development of actionable recommendations that drive measurable improvements in performance and support effective organizational transformation (required).
• Strong knowledge of managed vision care healthcare or retail revenue cycle processes billing systems and financial reporting (required).
• General understanding of finance and accounting processes insurance regulatory compliance and HR management of non-exempt employees (required).
• Strong analytical communication and leadership skills (required).
• Ability to manage multiple complex workstreams (preferred).
• Ability to collaborate with team members and counterparts to understand impacts to upstream and downstream business processes address challenges adapt implementation methodologies and ensure alignment with business objectives (required).

Additional Information :

Taking Care of Our People!

We understand the importance of financial health and security and because of that we provide competitive compensation to all associates. We also offer a comprehensive benefits package including health and dental insurance 401k retirement savings with company match flex spending account paid personal time off paid company holidays parental leave employee eyewear discount and much much more. At National Vision we strive to deliver opportunities for professional growth and long-term career fulfillment. We provide training programs and access to educational courses and pride ourselves on the ever-increasing amount of promotions from within.

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We are an equal opportunity employer.  We evaluate qualified applicants without regard to race color religion sex sexual orientation gender identity national origin genetic information disability veteran status and other legally protected characteristics.

Remote Work :

No

Employment Type :

Full-time