Senior Director, Revenue Cycle Management

Senior Director, Revenue Cycle Management

About The Oncology Institute (  ):
Founded in 2007, The Oncology Institute (NASDAQ: TOI) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI offers cutting-edge , evidence-based cancer care to a population of approximately 1.9 million patients , including clinical trials, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With over 180 employed and affiliate clinicians and over 100 clinics and affiliate locations of care across five states and growing, TOI is changing oncology for the better.

At The Oncology Institute, the Senior Director of Revenue Cycle Management is more than a financial leader—you are a catalyst for sustainable healthcare delivery. We empower you to shape enterprise-wide revenue strategy, modernize RCM operations, and lead high-impact teams that directly support patient access and organizational growth. You will have the autonomy and executive partnership to drive transformation across the full revenue cycle, leverage advanced analytics and technology, and influence decisions at the highest levels.

We value your expertise and trust your judgment, offering the resources, visibility, and support needed to deliver measurable results in a complex regulatory environment.

Role Summary

The Senior Director of Revenue Cycle Management (RCM) provides enterprise leadership for all non‑patient‑facing revenue cycle operations. This role sets strategy, standardizes processes, and drives performance excellence across eligibility and benefits verification, prior authorizations, billing, payment posting, accounts receivable follow‑up, self‑pay management, credit balance resolution/refunds, and provider credentialing/enrollment. The Executive Director is accountable for cash acceleration, denial prevention, regulatory compliance, and a best‑in‑class cost‑to‑collect while enabling access to care through timely, accurate financial clearance and payer readiness.

Key Responsibilities

Strategy, Leadership & Governance

• Build and execute the multi‑year RCM strategy for non‑patient‑facing functions; translate goals into annual operating plans, budgets, staffing models, and technology roadmaps.
• Lead, mentor, and develop a multi‑site leadership team; establish clear accountability, succession pipelines, and competency‑based training.
• Own RCM policies/SOPs, internal controls, and audit cadence to ensure standard work, scalability, and risk mitigation across all markets.

Eligibility & Benefits Verification

• Ensure accurate payer/plan capture, coordination of benefits (COB), and benefit calculations to enable clean claims and point‑of‑service collections.
• Set and monitor lead‑time targets (e.g., verification ≥7 days ahead of service when applicable), accuracy thresholds, and timeliness SLAs.
• Drive automation (270/271), payer portal/API use, and exception‑based workflows; reduce eligibility‑related rejections/denials.

Central Authorizations (Medical Necessity & Utilization Requirements)

• Oversee end‑to‑end prior authorization operations (including 278 transactions, clinical documentation routing, and peer‑to‑peer escalations).
• Optimize turnaround time (TAT) and first‑pass authorization rates; minimize avoidable write‑offs due to missing/expired auth or site‑of‑service requirements.
• Partner with clinical and contracting teams to align on coverage policies, medical necessity criteria, and payer rule changes.
• Achieve high clean claim rates through robust edits, charge capture reconciliation, correct payer selection, and coding integrity (with Coding/Compliance partners).
• Standardize clearinghouse workflows (837/835), claim status (276/277), and error correction queues; reduce avoidable rework and paper handling.

Payment Posting & Revenue Assurance

• Ensure timely and accurate cash posting, remit reconciliation, and denial code integrity to support downstream AR analytics and appeals.
• Expand ERA/EFT adoption and auto‑posting; establish posting timeliness SLAs (e.g., 24–48 hours of receipt) and suspense/exception resolution targets.
• Implement root‑cause analysis…