Job Description: Head of Delivery – Healthcare RCM BPO (AI-Enabled)
Role Title:
Head of Delivery – Healthcare RCM BPO (AI-Enabled)
Department:
Delivery & Operations – Healthcare Services
Reports To:
VP Delivery
Industry Focus:
Healthcare Revenue Cycle Management (RCM), BPO, AI-Enabled Operations
Company Overview
We are a global empathy-led technology services company where software and people transformations go hand-in-hand.
Product innovation and mature software engineering are part of our core DNA. Our mission is to help our customers accelerate their digital journeys through a global, diverse, and empathetic talent pool following outcome-driven agile execution. Respect, Fairness, Growth, Agility, and Inclusiveness are the core values that we aspire to live by each day.
We continue to invest in our digital strategy, design, cloud engineering, data, and enterprise AI capabilities required to bring a truly integrated approach to solving our client's most ambitious digital journey challenges.
Role Summary
The Head of Delivery – Healthcare RCM BPO (AI-Enabled) will lead end-to-end service delivery across the healthcare revenue cycle, including patient access, coding, billing, AR follow-up, denials, payments, and provider support operations. This role is responsible for scaling operations using AI, automation, analytics, and workflow intelligence to improve efficiency, accuracy, compliance, and client satisfaction.
Key Responsibilities
Delivery Leadership & Operations Management
• Oversee end-to-end delivery across all RCM towers: Patient Access, Medical Coding, Charge Capture, Billing, AR, Denials, Cash Posting, and Provider Helpdesk.
• Lead high-performance operations across multi-site, multi-client delivery centers.
• Build scalable operational frameworks supporting rapid growth, high productivity, and cost efficiency.
• Establish and manage SLAs, KPIs, quality metrics, and performance governance across all accounts.
AI-Enabled Transformation & Automation
• Champion the adoption of AI, ML, GenAI, NLP, OCR, RPA, and workflow automation for RCM processes.
• Evaluate and deploy AI-enabled RCM platforms for denial prediction, coding automation, AR optimization, and intelligent document processing.
• Partner with data and engineering teams to implement dashboards, process mining, and predictive analytics.
• Drive continuous automation to reduce manual effort, accelerate turnaround times, and improve margins.
Client Management & Growth
• Act as the senior delivery leader for enterprise healthcare clients including provider groups, MSOs, ASCs, hospitals, and payers.
• Ensure delivery excellence resulting in high NPS, retention, and revenue expansion.
• Collaborate with account management and sales to support renewals, expansions, and new solution offerings.
• Lead executive-level reviews, QBRs, and performance discussions with C-level stakeholders.
Compliance, Quality & Risk Management
• Ensure adherence to HIPAA, CMS, coding guidelines, and payer compliance standards.
• Establish quality frameworks that meet regulatory and client expectations.
• Mitigate operational risks through strong controls, governance, and audit readiness.
• Drive certification programs (AAPC, AHIMA, CHFP) for staff.
People Leadership & Organizational Development
• Lead large cross-functional teams including delivery, quality, training, and workforce management.
• Build leadership layers such as operations managers, senior managers, and process leads.
• Drive workforce planning, utilization, productivity improvement, and talent development.
• Promote a culture of accountability, learning, and innovation.
Required Qualifications
• 10+ years of experience in Healthcare RCM BPO operations with at least 3+ years in a delivery leadership role.
• Deep expertise across the full RCM lifecycle and strong understanding of US healthcare provider and payer ecosystems.
• Proven experience scaling 100–500+ FTE delivery operations across multiple clients.
• Strong background implementing AI/ML, automation, digital workflows, and analytics in RCM operations.
• Expertise in SLA management, lean/automation-driven improvements, and delivery governance.
• Experience managing P&L, operational budgets, margins, and account growth.
• Strong executive communication and client-facing leadership capability.
• Deep understanding of HIPAA, PHI, coding compliance, and industry standards.
Preferred Qualifications
• Experience with AI-based RCM tools including coding automation, denial prediction, and AR workflow intelligence.
• Exposure to deploying RPA solutions (UiPath, Automation Anywhere) and workflow/analytics platforms.
• Experience managing global delivery centers across India, Philippines, and the U.S.
• Professional certifications such as CHFP, CRCR, CPC, CCS, or Lean Six Sigma.
Key Competencies
• Operational Excellence & Delivery Leadership
• AI & Automation-Forward Mindset
• Strong Analytical & Process Optimization Skills
• Client-Centric Leadership & Executive Communication
• Strategic Thinking & Organizational Scaling
• Compliance & Risk Management Expertise
• High Ownership, Accountability & Execution Rigor