Requirements
Bachelor's Degree in Healthcare Administration, Business Administration, Finance, Health Information Management, Nursing, or related field. 5+ years of experience in Revenue Cycle Management, Healthcare Consulting, Patient Financial Services, Healthcare Operations, or related areas. Experience with revenue cycle processes including registration, insurance verification, coding, billing, claims adjudication, denials management, collections, and accounts receivable management. Strong understanding of healthcare reimbursement methodologies, payer operations, and regulatory requirements. Experience leading process improvement, business transformation, or operational excellence initiatives. Excellent analytical, problem-solving, communication, and stakeholder management skills. Demonstrated ability to manage multiple projects and deliver results in a client-facing environment. Proficient in healthcare analytics, reporting tools, and Microsoft Office applications.
Description
Job OverviewLead and support revenue cycle transformation initiatives for healthcare clients, driving operational efficiency, financial performance, and patient experience across the Revenue Cycle Management (RCM) continuum. Collaborate with stakeholders to analyze current processes, identify improvement opportunities, implement best practices, and deliver sustainable business outcomes.Essential FunctionsPartner with healthcare providers, payers, and internal stakeholders to assess, design, and optimize Revenue Cycle Management processes including Patient Access, Eligibility Verification, Prior Authorization, Charge Capture, Coding, Billing, Claims Management, Denial Management, Accounts Receivable, and Payment Posting.Conduct current-state assessments, process mapping, gap analysis, and root cause analysis to identify revenue leakage and operational inefficiencies.Lead business requirements gathering sessions and translate client needs into functional and operational solutions.Develop strategic recommendations to improve cash flow, reduce denials, enhance reimbursement accuracy, and optimize key revenue cycle KPIs.Manage multiple client engagements, ensuring project deliverables, milestones, and timelines are achieved with high quality and within budget.Facilitate stakeholder workshops, executive presentations, and governance meetings to communicate findings, recommendations, and project status.Support implementation of revenue cycle technologies, workflow automation solutions, reporting tools, and process improvement initiatives.Analyze operational and financial data to identify trends, performance gaps, and opportunities for improvement.Develop business cases, process documentation, standard operating procedures, training materials, and transformation roadmaps.Collaborate with cross-functional teams including clinical operations, finance, compliance, IT, and patient financial services.Ensure compliance with healthcare regulations, payer requirements, coding standards, and organizational policies.Mentor junior consultants and provide guidance on revenue cycle best practices and process improvement methodologies.Support proposal development, solution design, client presentations, and business development activities.Leadership ResponsibilitiesLead project teams and coordinate activities across multiple workstreams.Define resource requirements and support project staffing decisions.Monitor project performance, risks, issues, and dependencies.Drive continuous improvement initiatives and promote operational excellence.Provide coaching and professional development support to team members.Build and maintain strong client relationships and serve as a trusted advisor.QualificationsBachelor's Degree in Healthcare Administration, Business Administration, Finance, Health Information Management, Nursing, or related field.5+ years of experience in Revenue Cycle Management, Healthcare Consulting, Patient Financial Services, Healthcare Operations, or related areas.Experience with revenue cycle processes including registration, insurance verification, coding, billing, claims adjudication, denials management, collections, and accounts receivable management.Strong understanding of healthcare reimbursement methodologies, payer operations, and regulatory requirements.Experience leading process improvement, business transformation, or operational excellence initiatives.Excellent analytical, problem-solving, communication, and stakeholder management skills.Demonstrated ability to manage multiple projects and deliver results in a client-facing environment.Proficient in healthcare analytics, reporting tools, and Microsoft Office applications.Preferred QualificationsExperience with Epic, Cerner, Meditech, Athenahealth, or other healthcare information systems.Knowledge of Lean, Six Sigma, Agile, or Process Excellence methodologies.Experience working with hospitals, health systems, physician groups, or payer organizations.Relevant certifications such as HFMA, CRCR, Lean Six Sigma, PMP, or healthcare consulting certifications.Core CompetenciesRevenue Cycle OptimizationDenial Management & AR ImprovementHealthcare Operations ConsultingBusiness Process ReengineeringFinancial Performance ManagementClaims & Billing OperationsStakeholder ManagementData Analysis & ReportingProject ManagementChange ManagementHealthcare Technology EnablementStrategic Advisory Services IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.comIQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.