Associate Director - Solutions - REF108323C_2026270472 - Healthcare

Role: Revenue Cycle Management (RCM) Product Consulting

Position Summary

We are looking for a highly skilled professional to join as a Techno-Functional Expert in the field of RCM. This role will serve as a critical bridge between business stakeholders, domain experts, and technology teams and will contribute to the development of a next-generation RCM platform integrating outcome-driven automation and AI-powered capabilities, including but not limited to claims automation, autonomous coding, collections, analytics and denials management. The ideal candidate brings deep field-level knowledge of revenue cycle workflows and is adept at translating operational pain points into technical requirements for innovative, scalable solutions.

Key Responsibilities

Business Analysis & Requirements Gathering

• Engage with RCM stakeholders (operations, compliance, technology) to gather and document detailed business requirements across intake, coding, billing, claims, A/R, and denials.
• Define user stories, business rules, data flows, and system behavior aligned with operational outcomes.
• Work closely with product managers to prioritize features based on business value and technical feasibility.
• Partner with sales and account teams to shape solutions for new opportunities, contributing to solution design, proposals, due diligence, and client presentations.

 Subject Matter Expertise (SME)

• Provide domain expertise in U.S. healthcare revenue cycle processes and technologies.
• Offer field-level insights from front-end intake through back-end collections and appeals.
• Advise on industry best practices, compliance considerations, and emerging trends in automation and AI adoption in RCM.

 Techno-Functional Collaboration

• Act as a liaison between business users and development teams to ensure solution design aligns with functional needs.
• Partner with architects and engineers on data modeling, workflow engines, and AI/ML model integration.
• Participate in user acceptance testing (UAT), validating system outputs against business expectations.

 Platform Innovation

• Contribute to platform design and modularization of features such as (but not limited to)

o Claims Automation (e.g., OCR, NLP, intelligent form capture)

o Autonomous Coding (ICD/CPT code prediction using AI/ML)

o Process Optimization (clearinghouse logic, eligibility validation)

o Denials Prevention & Prediction (ML-based denial scoring, root cause analytics)

• Identify opportunities for AI/automation to enhance accuracy, reduce TAT, and minimize human intervention.
• Documentation & Change Management
• Develop clear documentation including BRDs, FRDs, process maps, and data dictionaries.
• Support training, change management, and knowledge transfer to internal teams and client stakeholders.

Bachelor's, BCA