Mgr Revenue Cycle

Role Overview:

The Manager, Revenue Cycle is responsible for overseeing the End-to-End (E2E) Premium Revenue Cycle, ensuring revenue transactions are accurate, complete, timely, and compliant across enrollment, payment processing, reconciliation, reporting, and issue resolution activities. This role provides strategic and operational leadership to maintain strong financial controls, support regulatory compliance, and drive continuous improvements that enhance revenue integrity and operational performance.

The Manager leads premium revenue operations, reconciliation activities, reporting, audits, process improvement efforts, and cross-functional initiatives. This position manages a team of analysts and coordinators while partnering closely with Accounting, Enrollment, EDI, Data Solutions, Actuarial, Compliance, Information Solutions, and other business stakeholders to ensure effective execution and oversight of premium revenue processes.

In addition, the Manager utilizes advanced analytical and data management tools, including SQL, Databricks, reporting platforms, and data visualization solutions, to monitor revenue performance, identify trends and anomalies, automate processes, strengthen data integrity, and support informed business decision-making throughout the premium revenue lifecycle.

Work Arrangement:

• Remote within the United States, working Eastern Standard Time.
• For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.
   

Responsibilities:

• Lead and oversee the End-to-End Premium Revenue Cycle, including reconciliation, reporting, discrepancy resolution, and operational performance.
• Manage, coach, develop, and evaluate Revenue Cycle staff while establishing performance expectations and development plans.
• Direct monthly, quarterly, and annual reconciliation processes and ensure timely completion of financial reporting deliverables.
• Partner with Accounting, Enrollment, EDI, Actuarial, Compliance, Data Solutions, and Information Solutions teams to resolve complex issues and improve business processes.
• Establish and maintain operational controls, audit readiness activities, policies, procedures, and governance standards.
• Lead strategic initiatives, automation opportunities, data modernization efforts, and process improvement projects.
• Oversee testing, implementation, and validation activities for new systems, enhancements, and regulatory changes
• Support departmental planning, budgeting, workforce allocation, and leadership reporting.
• Lead development and oversight of SQL queries, Databricks processes, automated reporting solutions, and data validation controls to improve revenue cycle efficiency and reporting accuracy. 
• Partner with Data Solutions and Information Systems teams to develop data models, dashboards, automated reconciliations, and scalable reporting solutions.
• Partner with the Automation & Innovation Enablement team to regularly review revenue cycle processes, identify opportunities for automation and optimization, evaluate emerging technologies, and implement efficient solutions that improve operational performance, strengthen controls, enhance reporting capabilities, and support continuous process improvement. 
• Perform other duties as assigned.
• Independent work capability combined with a collaborative mindset.

Education/Experience

• Bachelor’s Degree.
• Master’s Degree preferred.
• 5+ years of progressive experience in healthcare revenue cycle, finance, accounting, managed care operations, or financial reporting preferred.
   

Other Skills:

• Ability to identify issues, research, investigate, and document findings.
• Strong communication (both written and verbal), analytical and problem-solving skills.
• Strong organizational skills with the ability to coordinate several projects simultaneously.
• Experience with Azure Data Lake, data warehouses, and cloud-based analytical environments.
• Experience managing technical resources and analytics-focused teams.
• Knowledge of Power Platform (Power BI, Power Apps, Power Automate).
• Experience supporting data modernization, AI, predictive analytics, and automation initiatives.
• Experience working within Agile, DevOps, or project management frameworks.
• Advanced knowledge of healthcare revenue cycle operations, financial reporting, and reconciliation processes.
• Strong SQL skills including query development, joins, stored procedures, data validation, and troubleshooting.
• Experience utilizing Databricks for data extraction, transformation, validation, reporting, and analytics.
• Experience working with large datasets from multiple sources and translating business requirements into technical solutions.
• Knowledge of data governance, data quality controls, and revenue integrity principles.
• Advanced Excel skills including Pivot Tables, Power Query, and complex formulas.
• Experience with reporting and visualization tools such as Power BI.
• Ability to communicate complex technical concepts to operational and executive stakeholders.
• Experience leading automation and process improvement initiatives. 

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.