Oracle Health​/Cerner Revenue Cycle Management Workstream Project Manager

Oracle Health/Cerner Revenue Cycle Management Workstream Project Manager (Contract to Hire)

Contract to Hire: 6 Month Duration

W2 Only. Hybrid: 80% Remote 20% Onsite Boston, MA

Start Date:

Mid-Late January, Upon Successful Onboarding

Must Have Oracle Health/Cerner Implementation Experience Required.

The Oracle Health/Cerner Revenue Cycle Management Workstream Project Manager provides deep expertise across Oracle Health’s end-to-end revenue cycle ecosystem, including Rev Elate, legacy Cerner/Oracle RCM modules, EDI interfaces, financial workflows, and operational design. The architect leads the translation of revenue cycle operations into system build, testing strategies, data/financial integrity models, and future‑state operational workflows. This role is not a cloud engineer, but must understand how OCI hosting impacts Rev Elate, EDI, claim flows, environment refresh cycles, and operational performance.

• Lead enterprise architecture across Patient Access, Revenue Integrity, Charge Services, Billing, Claims, PFS, HIM, and Financial Clearance.
• Translate revenue cycle operational requirements into system design, build standards, and workflow architecture.
• Define encounter models, charge logic pathways, claims and remittance flows, and cross‑functional handoffs between clinical operations and revenue operations.
• Serve as the domain authority for Rev Elate’s account structure, workflow logic, reconciliation models, and operational implications.

• Account structure modeling.
• Charge event logic.
• Claim creation and submission rules.
• Work queues and staff workflows.
• Conversion considerations (pre‑ and post‑go‑live).
• Translate legacy workflows into Rev Elate equivalents, identifying operational and financial risks.

• Encounter conversion.
• Charge, payment, and adjustment data mapping.
• Aged A/R strategy (what to convert vs. close out).
• Reconciliation models and validation rules.
• Guide the financial integrity review cycles and defect remediation workflows.

• End‑to‑end operational flows.
• Charge capture accuracy.
• Payer‑specific rules and CRD/accelerated edits.
• Claims logic and denial scenario testing.
• Reimbursement modeling, underpayment triggers, and audit checkpoints.
• Partner with testing leadership to ensure scenarios cover complex payer mixes.

• Design and align across revenue cycle interfaces: X12/EDI, eligibility/authorization workflows, payer‑specific nuance.
• Ensure integration design supports real‑time revenue cycle operations and financial performance.

• Encounter/account preparation.
• Freeze logic for claims and charge processing.
• Transitional workflows (split claims, shadow claims, manual reconciliation).
• Charge capture and clinical documentation dependencies.
• Ensure stability in day‑1 to day‑90 revenue operations and defect triage.

• Environment provisioning and refresh cycles.
• Integration latency and message throughput.
• Rev Elate performance behaviors on OCI.
• Downtime workflows and revenue cycle contingency planning.
• EDI and clearinghouse connectivity pathways.
• DR/BCP implications for billing, claims, authorizations, and front‑end operations.

• Collaborate with clinical, technical, integration, data migration, and operational leads to ensure cohesive, end‑to‑end design.
• Mentor analysts and builders working across revenue cycle domains.
• Establish governance standards and reusable patterns for the EHR CoE.

• Serve as a trusted advisor to CFOs, VPs of Revenue Cycle, Directors, Clinical/Operational Leadership, and CIO/CTO partners.
• Communicate revenue cycle impacts and design decisions clearly, including risks and mitigation options.

• 5+ years of Oracle Health revenue cycle experience, spanning multiple domains.
• Experience with Rev Elate—workflow logic, build, account structure, and operational impacts.
• Expertise in revenue cycle architecture, EDI/claim workflows, financial testing, data migration, and cutover planning.
• Strong understanding of how OCI hosting affects revenue cycle performance.
• Ability to lead teams in complex, multi‑vendor implementations.
• Strong grounding in hospital and ambulatory revenue cycle operations.

• Experience with large‑scale EHR modernization.
• Background with AMCs, IDNs, multi‑hospital networks, or state agencies.
• Familiarity with CRD, coverage rules engines, authorization workflows, and Medicaid‑specific requirements.
• Prior consulting experience.