Revenue Cycle Manager Medicaid Waiver Program

Job Description: Revenue Cycle Manager – Medicaid Waiver Programs

Reports to: CFO

Employment Type: Full-Time

Location: Remote

Company Summary

StationMD is a telehealth company dedicated to serving individuals with intellectual and/or developmental disabilities (I/DD). All StationMD clinicians are board-certified and specially trained to treat individuals with I/DD. Clinicians are available 24/7 via telemedicine for urgent and non-urgent medical matters. StationMD also offers scheduled psychiatry visits via telemedicine to individuals with I/DD. In providing this suite of services, StationMD enables individuals with I/DD faster access to high-quality care and substantially reduces unnecessary medical costs.

Position Overview

StationMD is seeking an experienced Revenue Cycle Manager – Medicaid Waiver Programs to lead our multi-state waiver program billing operations, ensure compliance with state-specific Medicaid requirements, and optimize revenue cycle processes for our HCBS waiver participants. This role requires deep expertise in Medicaid billing, waiver program regulations, and revenue cycle management to ensure accurate and timely reimbursement while maintaining compliance across multiple waiver states.

Key Responsibilities

• Oversee end-to-end billing processes for 1915(c) HCBS waiver participants across multiple waiver states
• Oversee third-party billing vendors responsible for waiver claims processing and follow-up
• Ensure compliance with current state-specific Medicaid waiver billing requirements and regulations
• Manage claims submission, tracking, and follow-up for waiver services
• Coordinate with Health Information Managers to validate enrollment status and demographic data prior to billing
• Resolve billing discrepancies and denials in collaboration with state agencies and internal teams
• Develop and maintain comprehensive billing process and workflows for waiver programs
• Conduct regular billing audits to ensure accuracy and compliance with Medicaid requirements
• Implement process improvements to optimize billing efficiency and revenue capture
• Conduct monthly reconciliation of census reporting data, utilization reports, and billing cycles
• Create and maintain detailed reporting systems for waiver billing performance metrics
• Analyze billing trends and identify opportunities for revenue optimization
• Generate monthly and quarterly reports for leadership on billing performance and revenue
• Provide data-driven recommendations to improve billing processes and revenue capture
• Provide training and guidance on waiver-specific billing procedures and requirements
• Collaborate with account management teams on client billing issues and resolutions
• Partner with IT team to optimize billing system functionality and reporting capabilities

Required Qualifications

• 5+ years of experience in Medicaid billing including direct experience billing 1915(c) HCBS waiver programs
• Proven experience in revenue cycle management and healthcare billing operations
• Advanced proficiency in healthcare billing systems and revenue cycle management software
• Advanced knowledge of healthcare compliance and regulatory requirements
• Deep understanding of Medicaid regulations and waiver program requirements
• Strong attention to detail and accuracy in billing processes
• Excellent problem-solving abilities for complex billing issues
• Ability to manage multiple priorities and work effectively under pressure
• Strong communication skills for interaction with state agencies and internal stakeholders
• Strong analytical skills with proficiency in Excel

Preferred Qualifications

• Experience with telemedicine billing and reimbursement
• Certified Professional Coder (CPC) or similar healthcare billing certification
• Background in business intelligence or healthcare data analytics
• Previous experience managing billing teams in healthcare settings
• Familiarity with CRM systems and healthcare technology platforms

What We Offer

• Competitive salary commensurate with experience
• Comprehensive benefits package including health, dental, and vision insurance
• 401(k) retirement plan with company matching
• Professional development opportunities and continuing education support
• Flexible work arrangements and positive team culture
• Opportunity to make a meaningful impact on healthcare delivery for vulnerable populations

HealthTech Partners, Inc./StationMD PC is an equal opportunity employer