Apply on Employer Site

BackStretch · 7 hours ago

Director of Revenue Operations & Payer Relations (Healthcare)

California, United States

Full-time

Hybrid

Director/Executive

$130K/yr - $170K/yr

7+ years exp

BackStretch is a fast-growing California healthcare provider seeking a Director of Revenue Operations & Payer Relations to build and lead the financial backbone of its value-based care delivery model. This role requires strategic leadership to manage revenue operations, payer relations, and team development, ensuring compliance and optimizing performance in a complex healthcare environment.

Staffing & Recruiting

Hiring Manager

Kathleen Fecteau

Responsibilities

Own end-to-end revenue cycle for value-based care programs, from authorization to collection

Monitor key metrics (clean claim rates, denials, AR aging) and optimize performance through data-driven reporting

Ensure compliance with Medicaid/DHCS regulatory requirements and managed care plan standards

Drive continuous improvement across billing workflows, EHR platforms, clearinghouses, and payer portals

Identify and resolve bottlenecks in claims processing to improve speed and accuracy

Maintain audit-ready documentation and internal controls

Lead managed care plan negotiations, dispute resolution, and billing escalations

Serve as strategic advisor to executive leadership on revenue performance and financial risks

Partner with cross-functional teams (care coordination, compliance, finance, IT) to align clinical and billing workflows

Build and mentor a high-performing billing operations team with deep Medicaid managed care expertise

Deliver regular performance reports to CFO highlighting revenue capture, risks, and improvement opportunities

Qualification

Healthcare revenue cycle managementCalifornia Medicaid programsEHRsBilling softwareAnalyticalExecutive-level communicationProblem-solving skillsTeam developmentStakeholder managementContinuous improvementNegotiation skills

Required

Bachelor's degree in Business, Accounting, Healthcare Administration, or Finance

Minimum 7 years in healthcare revenue cycle management with demonstrated leadership of billing operations teams

Proven background in California Medicaid programs, including community-based care coordination models and alternative payment methodologies

Proficiency with EHRs, claims management systems, and billing software

Strong analytical and problem-solving skills with ability to drive change in evolving environments

Executive-level communication and stakeholder management abilities

Preferred

Advanced degree (MHA, MPH, or MBA) or professional credentials such as Certified Revenue Cycle Representative (CRCR), Certified Coding Specialist (CCS), or equivalent healthcare finance certifications

Experience with DHCS/CMS audits or California managed care value-based programs