Company Overview

A fast-growing California healthcare provider is seeking a Director of Revenue Operations & Payer Relations to build and lead the financial backbone of its value-based care delivery model. This role sits at the intersection of clinical excellence and financial sustainability, where your decisions directly impact the organization's ability to scale programs serving vulnerable populations.

You'll own an end-to-end revenue strategy for our managed care initiatives, troubleshoot complex payer relationships, and build a team equipped to navigate the nuances of California's Medicaid landscape. This is not a traditional back-office role, it's strategic leadership with hands-on depth.

Location: California (Southern/Central regions). Hybrid schedule available. Fully remote considered for exceptional candidates with proven Medi-Cal leadership.

Responsibilities:

Revenue Operations

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

Systems & Process Improvement

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

Payer Relations & Leadership

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

Team Development

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

Requirements:

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

Compensation & Impact

Base Salary: $130,000 - $170,000 + bonus

Benefits: Full package (medical, dental, vision, retirement, professional development support)

Why This Matters: You'll directly shape how a mission-driven organization sustains and expands care for high-risk, underserved populations. Lead a team. Influence strategy and solve real operational complexity.

Next Step: Ready to apply? No cover letter required. Interviews start immediately.

Job Type: Full-time

Pay: $130,000.00 - $170,000.00 per year

Benefits:

401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance

Work Location: Remote

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Director of Revenue Operations & Payer Relations (Healthcare)