Revenue Cycle (RCM) Manager

Role Overview

As a strategic leader at Badruddin Medical, the Revenue Cycle (RCM) Manager will assume full accountability for the end-to-end performance, transformation, and financial stewardship of the Revenue Cycle Management function. This pivotal role demands a dynamic professional capable of building and scaling a high-performing RCM operating model while driving innovation, change management, and sustainable financial growth. The ideal candidate will optimize revenue conversion across all streams, foster strong payer relationships, and collaborate with stakeholders to enhance patient and family experiences. Additionally, the role will support compliant, commercially viable, and operationally efficient growth in alignment with value-based healthcare principles.

Key Responsibilities

• Lead and Scale RCM Operations: Establish and enforce robust operating standards, performance discipline, team capability, and cross-functional coordination to ensure seamless RCM function execution.
• Drive Financial and Revenue Performance: Maximize legitimate revenue capture and cash conversion while minimizing revenue leakage. Maintain accurate forecasting, financial visibility, and resource efficiency to sustain long-term financial health.
• Develop and Manage Payer Relationships: Cultivate strategic payer partnerships, including network development, reimbursement negotiations, and evaluation of commercially viable and sustainable payer arrangements, with a focus on emerging value-based reimbursement models.
• Oversee RCM Performance Across Patient Pathways: Ensure effective Patient Access, patient flow, and service delivery for both insured and self-pay patients, aligning all processes with value-based care principles.
• Safeguard Revenue Integrity: Maintain rigorous standards across the clinical-to-cash continuum, including documentation integrity, chargemaster governance, and RCM master data management, in collaboration with clinical and operational stakeholders.
• Lead Claims, Collections, and Receivables Recovery: Drive efficient claims processing, denials and appeals management, underpayment recovery, payer follow-up, and root-cause improvement initiatives to optimize reimbursement and cash performance.
• Spearhead Technology Transformation: Lead RCM business requirements for technology advancements, automation, and process optimization, ensuring seamless system integrations, data integrity, and information flow in partnership with technology stakeholders.
• Ensure Compliance and Risk Management: Uphold stringent RCM compliance, risk, and control standards, promptly addressing and escalating significant compliance or control issues to mitigate financial and operational exposure.
• Deliver Strategic Management Reporting: Provide concise, decision-oriented reports on RCM performance, financial exposure, and critical priorities requiring leadership attention to drive informed decision-making.

Qualifications & Experience

To excel in this role, candidates must possess the following qualifications and experience:

• Language Proficiency: Professional fluency in both Arabic and English, including speaking, reading, and writing.
• Relevant Experience: Minimum of 10 years of progressive, directly relevant experience in healthcare RCM or medical insurance, with a proven track record in management and leadership roles.
• Transformational Leadership: Demonstrated ability to transform and scale RCM functions, lead multidisciplinary teams, manage payer relationships, and deliver measurable financial and operational outcomes.
• Saudi Healthcare Knowledge: In-depth understanding of the Saudi healthcare insurance and reimbursement landscape, including regulations and requirements from entities such as CHI, Insurance Authority, NHIC, nphies, SBS, and other relevant bodies.
• Professional Certifications: Strong preference for relevant certifications such as CRCR-GCC, IFCE, CHFP, or equivalent. CPC or CCS specialist credentials are valued, with the advanced EHRC designation highly regarded.
• Educational Background: A Bachelor’s degree in Healthcare Management, Health Informatics, Economics, Business Administration, Accounting, Finance, or a related field. A Master’s degree in a relevant discipline is strongly preferred.
• Preferred Qualifications: A relevant medical or clinical qualification, though not mandatory.