Prochant is seeking a highly experienced RCM leader to join as Associate Director – Quality RCM Operations. This role will lead enterprise‑wide quality initiatives across revenue cycle operations, ensuring compliance, accuracy, and performance excellence. The Associate Director will be responsible for driving quality governance, SLA adherence, client satisfaction, and continuous improvement across intake, eligibility verification, prior authorization, billing, and AR functions.
This is a senior leadership role for professionals who have managed large‑scale US healthcare operations and can influence outcomes across people, process, and clients through a strong quality and compliance lens.
Key Responsibilities
Quality & Compliance Leadership
- Establish and oversee quality frameworks across end‑to‑end RCM operations.
- Ensure compliance with Medicare, Medicaid, and Commercial payer rules.
- Drive audit readiness, error prevention, and adherence to regulatory standards.
- Monitor intake accuracy, eligibility validation, benefits verification, and authorization quality.
Delivery Excellence & Client Management
- Ensure consistent delivery against SLAs, KPIs, and quality benchmarks.
- Act as senior escalation point for client issues related to quality gaps, compliance errors, or denials.
- Build strong client partnerships through proactive communication and performance governance.
- Drive improvements in first‑pass yield, clean claim rates, and denial prevention.
Process Improvement & Automation
- Lead process standardization, SOP governance, and operational controls.
- Drive productivity improvement, cost optimization, and automation initiatives (payer portals, RPA, workflow tools).
- Track payer policy changes and ensure operational readiness across teams.
People & Leadership Development
- Mentor and develop senior managers, managers, and team leaders with a focus on quality culture.
- Build a strong leadership pipeline through structured training, performance management, and succession planning.
- Ensure continuous skill upgradation aligned with payer rules, regulatory updates, and client expectations.
Strategic Alignment
- Partner with senior leadership to align quality operations with organizational strategy, growth plans, and client expansion.
- Support new client onboarding, volume ramp‑ups, and service line expansions with quality oversight.
Key Skills & Competencies
- Deep expertise in US healthcare RCM quality management.
- Strong understanding of payer rules, compliance standards, and audit frameworks.
- Proven experience managing large‑scale operations (500+ FTEs preferred).
- Strong domain knowledge across intake, eligibility verification, PA coordination, billing, and AR.
- Excellent client engagement, stakeholder management, and executive communication skills.
- Track record in process improvement, automation, and operational transformation.
- Strategic mindset with strong decision‑making and people leadership capabilities.
Qualifications
- Graduate / Postgraduate in any discipline.
- 15+ years of overall US healthcare RCM operations experience.
- 7+ years in leadership roles managing managers and large delivery teams.
Why Join Prochant
- Senior leadership role in a fast‑growing US healthcare RCM organization.
- Opportunity to own and shape quality strategy across the RCM lifecycle.
- Exposure to technology‑led quality transformation and automation.
- Work from DLF Cybercity, Chennai, Prochant's primary India delivery hub.
- Collaborative culture with strong focus on leadership impact and career growth.
