RCM Vendor Management

The Manager of Vendor Management (RCM) is responsible for overseeing, optimizing, and strengthening relationships with third-party vendors that support the healthcare revenue cycle. This role ensures vendors deliver services that align with organizational objectives, compliance standards, and performance benchmarks, while continuously seeking opportunities to enhance financial performance, operational efficiency, and patient experience.

Key Responsibilities

1. Vendor Oversight & Relationship Management

1. Serve as the primary point of contact for all RCM vendor relationships (e.g., billing, collections, coding, eligibility, denial management).

2. Negotiate, review, and manage vendor contracts and service level agreements (SLAs).

3. Monitor vendor compliance with contractual, regulatory, and organizational requirements.

4. Foster collaborative, performance-driven partnerships with vendors.

1. Performance Management & Analytics

   1. Establish and track vendor KPIs (collections, DSO, denial rates, clean claim rate, etc.).

   2. Conduct regular performance reviews with vendors and internal stakeholders.

   3. Identify underperforming vendors and develop corrective action plans.

   4. Prepare and present vendor scorecards, dashboards, and executive-level reports.

2. Operational & Financial Optimization

   1. Partner with internal RCM leadership to align vendor services with strategic revenue cycle goals.

   2. Drive initiatives to reduce denials, improve cash acceleration, and optimize patient financial outcomes.

   3. Evaluate cost-effectiveness of vendor solutions; recommend opportunities for savings or reinvestment.

   4. Ensure integration of vendor services with internal RCM operations and technology platforms (e.g., Epic, Cerner, Athena).

3. Compliance & Risk Management

   1. Ensure vendor adherence to HIPAA, CMS, payer requirements, and organizational compliance policies.

   2. Mitigate risk by maintaining strong oversight of vendor handling of PHI and financial data.

   3. Partner with compliance and legal teams to address audit findings or escalations.

Qualifications

1. Bachelor's degree in Business Administration, Healthcare Administration, Finance, or related field (Master's preferred).

2. 5+ years of progressive experience in healthcare revenue cycle management, with at least 2–3 years in vendor or contract management.

3. Proven success in managing vendor performance, contract negotiations, and financial outcomes in a healthcare RCM environment.

Skills & Competencies

1. Strong knowledge of RCM processes: patient access, coding, billing, denials, A/R, collections.

2. Excellent negotiation, relationship management, and vendor governance skills.

3. Analytical mindset with the ability to interpret data and drive actionable insights.

4. Strong communication and presentation skills with executive presence.

5. Proficiency with RCM technology platforms (Epic, Cerner, Athena, Meditech) and vendor performance dashboards.

Key Success Metrics

1. Vendor SLA and KPI achievement (collections, DSO reduction, denial turnaround).

2. Improved NCR (net collection rate) and reduced A/R >120 days.

3. Cost savings and/or ROI from vendor contracts.

4. Compliance audit readiness and vendor risk mitigation.

5. Strengthened vendor partnerships aligned with organizational RCM goals.