RCM QA Supervisor - Backend - Multiple Sites

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Primary Responsibilities:

• RCM Operations & Process Management
  • Oversee end-to-end Revenue Cycle Management processes, including claims processing, denial management, and payment posting
  • Drive process improvements and implement automation strategies for efficiency
  • Ensure adherence to SLAs and KPIs for operational excellence
• Compliance & Audits
  • Ensure compliance with regulatory guidelines such as HIPAA, SOX, and corporate standards
  • Participate in internal and external audits and maintain accurate documentation
  • Align processes with organizational and industry compliance requirements
• Stakeholder Management
• Communicate effectively with clients, leadership, and cross-functional teams
• Build strong relationships with business partners and manage escalations promptly
• Act as a key liaison for all RCM-related matters
• Team Leadership & Training
  • Lead and mentor teams to achieve performance goals
  • Foster a culture of continuous improvement and data-driven decision-making
• Analytics & Decision-Making
  • Utilize data analysis to identify trends and drive strategic decisions
  • Conduct root cause analysis and implement predictive analytics for process optimization
  • Prepare and present reports to leadership for informed decision-making
• Planning & Budgeting

• Develop operational budgets and ensure cost control
• Lead projects focused on process improvement and automation
• Create and execute RCM roadmaps aligned with business objectives

• 2+ years in Healthcare Industry & People Management
• Good Knowledge of HealthCare Industry

• Proven experience in managing Revenue Cycle Management (RCM) operations and driving process improvements
• Ability to clearly connect and communicate with key stakeholders and leadership team for strategic decision-making
• Solid communication and presentation skills to influence and align cross-functional teams
• Proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook) for reporting and analysis
• Understanding project management principles and ability to manage multiple initiatives simultaneously
• Analytical mindset with a focus on data-driven decision-making and performance metrics