CalAIM Revenue Cycle Manager

About the role

IOA is a provider of innovative healthcare models for aging adults and adults with disabilities, offering programs that help seniors stay healthy, independent and connected to their communities. The CalAIM Revenue Cycle Manager leads the CalAIM billing, claims and accounts receivable operations, overseeing the full lifecycle of a claim from data capture to payment, covering Enhanced Care Management (ECM) and Community Supports (CS). The manager works closely with Accounting, Finance, Operations and Program Leadership to drive compliance, reduce denials and optimise cash flow.

Key responsibilities

• Lead day-to-day billing, claims and accounts receivable operations, including timely, compliant claim submission, payment posting, denial management, appeals, collections and reimbursement.
• Supervise and coach billing and claims staff, setting performance expectations and monitoring productivity.
• Monitor revenue cycle performance (claims, denials, AR aging, collections, KPIs), analyse trends and implement corrective actions.
• Ensure compliance with CalAIM, DHCS, Medi-Cal, payer contracts and federal, state and organisational policies.
• Act as primary liaison with Managed Care Plans and other payers on billing, authorisation, eligibility, payment and reimbursement issues.
• Partner with Operations, Clinical and Program leadership to improve documentation, billing accuracy, workflow and internal controls.
• Support financial operations: calculate and report monthly revenue, assist with revenue recognition, reconciliations, audits, month-end close, budgeting, forecasting and regulatory reporting.
• Lead process improvements, system enhancements, payer onboarding and new program implementations, and maintain departmental policies and training.

Required profile

• Bachelor's degree in Healthcare Administration, Business Administration, Accounting, Finance or a related field, or equivalent education and experience.
• Five or more years of progressive healthcare revenue cycle, medical billing or accounts receivable experience.
• At least two years of leadership or supervisory experience over billing or revenue cycle staff.
• Demonstrated expertise in Medi-Cal Managed Care, CalAIM billing and commercial payer reimbursement, and proven success with denials, appeals and AR recovery.
• Preferred: direct CalAIM experience (ECM and CS), billing for home health, community-based services, behavioural health or value-based care, revenue cycle process improvement experience, and professional certification such as CPB or CRCR.

Required skills

• Proficiency with EMR/EHR systems, billing software and Microsoft Excel, including reporting and data analysis.
• Strong analytical, organisational, leadership and project management skills.
• Excellent written, verbal and interpersonal communication.

Work arrangement: hybrid, with a minimum of three days per week on site. Salary range: $120,000 - $125,000 per year.