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Full-time
bachelor degree
Posted 1d ago
~40 hrs/week
Responsibilities
Lead and support revenue cycle transformation initiatives to improve operational efficiency and financial performance for healthcare clients. Manage client engagements, facilitate stakeholder workshops, and implement process improvements across the revenue cycle continuum.
Requirements
Requires a Bachelor's degree in a relevant field and at least 5 years of experience in Revenue Cycle Management or healthcare consulting. Candidates must possess strong analytical skills and expertise in healthcare reimbursement, billing, and process optimization.
Full job description
Job Overview
Lead 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 Functions
Partner 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 Responsibilities
Lead 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.
Qualifications
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.
Preferred Qualifications
Experience 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 Competencies
Revenue Cycle Optimization
Denial Management & AR Improvement
Healthcare Operations Consulting
Business Process Reengineering
Financial Performance Management
Claims & Billing Operations
Stakeholder Management
Data Analysis & Reporting
Project Management
Change Management
Healthcare Technology Enablement
Strategic 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.com
IQVIA 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.
Related keywords
Revenue Cycle ManagementHealthcare AdministrationProcess MappingGap AnalysisRoot Cause AnalysisKPIsEpicCernerMeditechAthenahealthLeanSix SigmaAgileHFMACRCRPMP
IQVIA (NYSE:IQV) is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. IQVIA’s portfolio of solutions are powered by IQVIA Connected Intelligence™ to deliver actionable insights and services built on high-quality health data, Healthcare-grade AI™, advanced analytics, the latest technologies and extensive domain expertise. With approximately 88,000 employees in over 100 countries, including experts in healthcare, life sciences, data science, technology and operational excellence, IQVIA is dedicated to accelerating the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.
IQVIA is a global leader in protecting individual patient privacy. The company uses a wide variety of privacy-enhancing technologies and safeguards to protect individual privacy while generating and analyzing information on a scale that helps healthcare stakeholders identify disease patterns and correlate with the precise treatment path and therapy needed for better outcomes. IQVIA’s insights and execution capabilities help biotech, medical device and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders tap into a deeper understanding of diseases, human behaviors and scientific progress, in an effort to advance healthcare. To learn more, visit www.iqvia.com.
Offices: 2400 Ellis Rd, Durham, North Carolina 27703, US