Director, RCM Shared Services
Tennessee Oncology · United States
OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.
Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.
Job Description:
Role Summary
The Director, RCM Shared Services (Urology) is responsible for leading strategic and operational initiatives for practice-based revenue cycle management (RCM) teams, third-party RCM vendors, and internal OneOncology stakeholders supporting urology practices. This position drives revenue cycle projects, utilizes analytics to optimize performance, implements best-practice workflows, and leads corporate in-house RCM teams focused on maximizing financial outcomes while maintaining exceptional patient and provider experiences.
Responsibilities
Ensure accurate coding, charge capture, and reimbursement for urology office visits, diagnostic testing, surgical procedures, surgeries and ancillary services.
Manage relationships with third-party revenue cycle vendors and global service partners as well as leading a US-based team.
Oversee revenue cycle processes related to cystoscopy, prostate biopsy, urodynamics, imaging, ultrasound, lithotripsy, vasectomy, catheter management, and other common urologic procedures and surgeries.
Manage pre-authorization and medical necessity workflows for surgical and procedural services, including hospital and ambulatory surgery center cases.
Monitor payer reimbursement trends and regulatory changes impacting urology services and develop strategies to mitigate financial risks.
Partner with management, coding, compliance, and provider leadership to ensure appropriate application of CPT, HCPCS, ICD-10-CM, and modifier usage specific to urology services.
Oversee denial prevention and appeals processes for specialty-specific procedures, surgical claims, medical necessity denials, and bundled service edits.
Ensure optimization of ancillary revenue streams, including pathology, laboratory, imaging, dispensing pharmacy, and other practice-based services.
Collaborate with management, providers and practice leaders to improve charge capture, documentation quality, and reimbursement outcomes.
Analyze procedure utilization, reimbursement performance, RVU productivity, denial trends, and net collection metrics to identify opportunities for improvement and report out on these metrics.
Support implementation and optimization of practice management systems, EMRs, coding edits, and automation tools to improve revenue cycle effectiveness.
Serve as a subject matter expert regarding urology/surgery reimbursement regulations, payer policies, fee schedules, and revenue cycle best practices.
Ensure compliance with Medicare, Medicaid, commercial payer, and governmental regulations related to urologic services and physician practice billing.
Lead revenue cycle readiness and integration efforts for acquisitions, new providers, service line expansions, and newly implemented ancillary services and any assigned lines of business.
Monitor vendor performance using established KPIs, SLAs, and operational metrics.
Collaborate with RCM team to improve reimbursement, collections, denial management, and workflow efficiency.
Serve as the primary contact for division RCM communications, issue resolution, and performance reviews actively collaborating with management on identified issues.
Ensure vendor compliance with contractual requirements, organizational policies, and regulatory standards.
Qualifications
5+ years of relevant healthcare and RCM leadership experience.
Bachelor’s degree or equivalent experience required.
Experience managing third-party revenue cycle vendors or outsourced RCM services preferred.
Contract management and vendor oversight experience preferred.
Coding certification preferred
Strong background in managed care payer market
Urology experience required.
Strong verbal and written communication skills required.
Must be detail oriented and organized
Strong Microsoft Office skills required, including Excel and PowerPoint.
High integrity, including maintenance of confidential information
Ability to work a flexible schedule based on business need, including some evenings and weekends.
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