AVP Revenue Cycle Management(US Night shifts)

Genpact · Uttar pradesh, India

Position Summary

The Global Process Owner (GPO) - Home Health RCM owns the end-to-end governance, standardization, performance management and transformation of Home Health Revenue Cycle Management processes. The role acts as the single point of accountability for process effectiveness, efficiency, compliance and continuous improvement across clients, delivery centers, geographies and enabling functions.

The incumbent will establish global standards, drive strategic transformation, enable digital adoption and ensure operational, financial and customer outcomes across the Home Health revenue cycle in partnership with Operations, Technology, Analytics, Quality, Compliance and Client Leadership teams.

Process Scope

Home Health RCM Process Scope

• Billing & Claims Submission

• Clearinghouse & Rejection Management

• Payment Posting & Reconciliation

• Accounts Receivable Management

• Denial Prevention & Appeals

• Collections & Cash Acceleration

• Credit Balance Management

• Revenue Integrity

• Performance Reporting & Analytics

Key Responsibilities

1. End-to-End Process Ownership

• Define standard process flows, SOPs, work instructions, control checkpoints, RACIs and escalation paths.
• Approve deviations, process exceptions and changes while ensuring consistent adoption across delivery teams.
• Act as the Voice of Process in client, operations, technology and leadership governance forums.

2. Process Design, Governance & Standardization

• Design future-state operating models focused on scalability, standardization, compliance and digital enablement.
• Lead process design sign-offs, standard operating procedure updates, policy alignment and best-practice adoption.
• Monitor industry, payer, regulatory and technology changes that impact Home Health billing and revenue cycle outcomes.
• Partner with functional leaders to align service delivery, controls, reporting and transformation priorities.

3. Transformation & Continuous Improvement

• Create and govern a multi-year Home Health RCM transformation roadmap linked to productivity, quality, compliance, revenue and stakeholder experience goals.
• Lead Lean Six Sigma initiatives using DMAIC, value-stream mapping, root cause analysis, FMEA and Kaizen.
• Identify and sponsor automation, RPA, AI/analytics, workflow optimization, EHR enhancement and dashboarding opportunities.
• Track benefits realization, milestones, risks, dependencies and adoption through structured governance.

4. Performance Management & KPI Governance

• Define and govern Home Health RCM performance metrics, scorecards, SLA controls and benchmarking framework.
• Review operational and financial performance, identify gaps and sponsor corrective actions with delivery teams.
• Govern executive dashboards covering productivity, quality, billing timeliness, clean claim rate, first-pass yield, denials, AR aging, NRR / NCR, cost-to-collect and cash performance.
• Provide leadership visibility on improvement opportunities, transformation progress and measurable business impact.

5. Stakeholder, Policy, Risk & Compliance

• Facilitate process councils, governance reviews, transformation steering committees and executive updates.
• Own Home Health RCM policies, procedures, process controls and monitoring mechanisms.
• Ensure alignment with CMS, HIPAA, Medicare, commercial payer policies, client requirements and internal audit controls.
• Identify policy/control gaps, conduct risk assessments and implement remediation plans.

Required Skills & Competencies

Domain & Transformation Skills

• Deep U.S. healthcare RCM expertise across Patient Access, Billing, AR, Denials, Payment Posting and Collections.

• Strong understanding of Home Health / post-acute revenue cycle nuances, payer behavior, reimbursement and denial drivers.

• Lean Six Sigma, transformation roadmap, process re-engineering and benefits-realization capability.

• Strong analytics, KPI interpretation, governance and executive reporting skills.

Leadership Behaviours

• Strategic thinker with ability to deep dive into process-level defects and controls.

• Change leader and effective communicator who can influence without direct authority.

• Strong stakeholder manager across client, operations, technology, quality and compliance teams.

• Ability to build process capability, SME networks, training paths and best-practice communities.

Qualifications

• Bachelor’s degree required.
• 12-18+ years of Healthcare RCM experience, with significant exposure to Home Health / post-acute RCM preferred.
• Experience leading large-scale transformation, operating model redesign, RPA, analytics, workflow platforms and EHR / billing systems
• Lean Six Sigma Green Belt / Black Belt preferred; PMP, Agile or equivalent certification preferred.
• Exposure to AI and working with third parties service provider is preferred.