Director of Revenue and Contract Management

United States·BrocktonRegularexecutive

Other

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Position Summary The Director of Revenue Cycle and Contract Management provides enterprise leadership for BAMSI's revenue lifecycle,

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The Director of Revenue Cycle and Contract Management provides enterprise leadership for BAMSI's revenue lifecycle, from contract interpretation and service documentation through billing, collection, reconciliation, and financial reporting. Reporting to the Chief Financial Officer, the director is accountable for maximizing timely and accurate revenue from Massachusetts state agencies, including the Department of Developmental Services and Department of Mental Health, as well as MassHealth, commercial insurers, managed-care entities, and other third-party funders.

The role establishes reliable controls that connect contracts, authorizations, services delivered, claims, cash receipts, accounts receivable, and the general ledger. The director works closely with the CFO, Controller, program operations, clinical leaders, contracting, compliance, information technology, and external funders to reduce revenue leakage, resolve denials and underpayments, improve cash flow, and support accurate revenue recognition in accordance with contract terms and generally accepted accounting principles.

Responsibilities

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Lead monthly revenue close activities for government contracts, grants, fee-for-service programs, and third-party payers; provide complete, accurate, and timely revenue schedules to the CFO and Controller.
Reconcile services delivered, billing system activity, remittances, cash receipts, accounts receivable, deferred or unearned revenue, contract balances, and general-ledger revenue accounts.
Evaluate contract terms, funding conditions, rate structures, and service data to support the appropriate timing and classification of revenue in partnership with the CFO and Controller.
Develop estimates and supporting schedules for earned but unbilled revenue, contractual allowances, denials, reserves, write-offs, and other revenue adjustments.
Investigate variances between contracted amounts, authorized units, services delivered, invoices or claims submitted, payments received, and revenue recorded; drive issues through resolution.
Maintain auditable documentation and standardized controls for revenue calculations, reconciliations, journal-entry support, and balance-sheet substantiation.
Prepare revenue cycle reports, dashboards, and executive-level presentations.
Analyze billing trends, reimbursement issues, and collection performance.

Maintain a centralized inventory of active funding agreements, amendments, rates, service models, billing rules, reporting obligations, renewal dates, and key contacts.
Interpret financial and billing provisions for DDS, DMH, and other public funding agreements, including unit-rate, cost-reimbursement, allocation-based, and performance-based arrangements.
Partner with operational leaders to confirm that staffing, census, utilization, authorizations, service documentation, and program activity support complete and accurate billing.
Monitor contract utilization, spending plans, encumbrances, amendments, rate changes, funding limits, and closeout requirements; identify underutilization or revenue risk early.
Prepare or coordinate invoices, expenditure reports, reconciliations, cost reports, and other financial submissions required by funders.
Serve as the principal Finance contact for revenue-related inquiries, discrepancies, audits, payment delays, and contract closeout discussions with funders.

Provide oversight of the end-to-end third-party revenue cycle, including eligibility and authorization controls, charge capture, coding interfaces, claim submission, remittance posting, denial management, follow-up, collections, and appeals.
Establish billing calendars and work queues that support timely submission of clean claims and invoices within payer and contract deadlines.
Monitor payer enrollment, credentialing dependencies, fee schedules, authorization requirements, claim edits, timely-filing limits, and changes in payer rules.
Analyze denials, rejections, underpayments, aging, unapplied cash, and credit balances; assign corrective actions and escalate systemic barriers.
Direct collection activity for outstanding government and third-party receivables while maintaining professional relationships with funding partners.
Approve or recommend adjustments, refunds, write-offs, and reserve changes in accordance with BAMSI policy and delegated authority.
Oversee all third-party billing activities, including electronic claim submission and payment reconciliation.
Maintain expert knowledge of Medicare, Medicaid, Managed Care, Commercial Insurance, and value-based reimbursement models.
Manage relationships with insurance carriers and payer representatives.

Design and maintain written procedures, segregation of duties, approval thresholds, reconciliation standards, and documentation requirements across the revenue cycle.
Ensure billing practices are supported by services rendered, required documentation, authorizations, contract terms, and applicable federal and Massachusetts requirements.
Partner with Compliance, Quality, Legal, and program leadership to investigate potential billing errors, overpayments, duplicate payments, or other revenue-integrity concerns and coordinate corrective action.
Support annual financial audits, Uniform Financial Reports, funder reviews, cost reports, and other regulatory or contractual examinations by producing accurate schedules and documentation.
Monitor record-retention requirements and safeguard confidential financial and protected health information.

Develop dashboards and routine reports covering billed and unbilled revenue, days in accounts receivable, aging, denial rates, clean-claim performance, cash collections, contract utilization, write-offs, and forecast-to-actual results.
Translate revenue data into clear forecasts, risks, and recommended actions for the CFO, executive leadership, and program owners.
Partner with Information Technology and system owners to improve interfaces among electronic health records, billing platforms, contract data, banking activity, and the general ledger.
Lead root-cause analysis and process redesign to reduce manual work, prevent revenue leakage, accelerate cash collection, and improve data quality.
Establish data ownership, validation routines, and exception reporting for census, authorizations, rates, service units, claims, remittances, and receipts.

Lead, coach, and develop assigned billing, revenue, and accounts-receivable staff; set priorities, performance expectations, service standards, and cross-training plans.
Create a culture of accountability, timely follow-through, customer service, continuous improvement, and ethical revenue stewardship.
Partner with Finance, Operations, Clinical Services, Contracts, Compliance, and Human Resources to clarify responsibilities and resolve issues affecting revenue.
Educate program and administrative teams on the operational practices, documentation, deadlines, and data quality required to secure reimbursement.
Participate in new-program, new-contract, payer, and system implementations to ensure billing, accounting, reporting, and control requirements are addressed before launch.

Requirements

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Bachelor's degree in accounting, finance, business administration, healthcare administration, or a related field.
At least seven years of progressively responsible experience in revenue cycle, reimbursement, billing, accounts receivable, contract finance, or revenue accounting, including at least three years in a leadership or supervisory capacity.
Demonstrated experience with third-party billing and collection processes, including claim submission, remittance posting, denial resolution, aging management, and payer follow-up.
Experience managing and reconciling government contracts, grants, or publicly funded human-services or healthcare revenue.
Strong working knowledge of GAAP, revenue recognition, internal controls, month-end close, account reconciliation, and audit support.
Advanced analytical and spreadsheet skills, with the ability to work across financial, billing, contract, and operational systems.
Ability to interpret complex contracts and payer requirements, communicate findings clearly, and influence action across departments.
Demonstrated sound judgment, attention to detail, confidentiality, integrity, and ability to manage competing deadlines.

CPA, MBA, MHA, or other relevant graduate degree or professional credential.
Revenue-cycle leadership experience in a Massachusetts nonprofit human-services, behavioral-health, developmental-services, healthcare, or community-based organization.
Direct experience with Massachusetts DDS, DMH, MassHealth, managed-care organizations, and commercial insurance billing or funding arrangements.
Experience with cost-reimbursement, unit-rate, grant, and performance-based contracts and related closeout or cost-reporting requirements.
Experience implementing billing, electronic health record, enterprise resource planning, contract-management, or business-intelligence tools.

This position operates primarily in a professional office environment and supports a multiple programs. Hybrid work may be available in accordance with BAMSI policy and business needs. Travel among BAMSI locations and occasional extended hours during month-end, year-end, audits, contract closeouts, or urgent payer matters may be required. The position routinely uses computers and other standard office equipment and handles confidential financial and health-related information.

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