General Manager - RCM Quality (US Healthcare)

SUMMARY:

As a GM quality, you will be involved in the full lifecycle of RCM. Manage and report adherence to service levels as agreed with client. Responsible for Customer satisfaction measured through CSAT & ESAT scores.

Ensure Best-In-Class process/system are deployed for the set revenue and cost goals. Excellent communication skills, attention to detail, and strong technical and problem solving skills are essential aspects of this role. Must be well versed with financial numbers and P&L reporting.

Key Responsibilities

• Lead Quality Assurance initiatives across US Healthcare Revenue Cycle Management (RCM) processes.
• Conduct quality audits for Billing, AR Follow-up, Denials, Payment Posting, and related RCM functions.
• Monitor process quality metrics and ensure process health scores meet defined targets.
• Perform Root Cause Analysis (RCA) for quality issues and drive corrective and preventive actions (CAPA).
• Identify training needs based on audit findings and collaborate with operations teams for skill improvement.
• Prepare and present MIS reports, quality dashboards, and performance insights to leadership and clients.
• Ensure compliance with client requirements, SOPs, and regulatory guidelines.
• Drive continuous improvement initiatives to enhance accuracy, productivity, and customer satisfaction.
• Partner with Delivery Heads, Operations teams, and clients to improve process performance.
• Support recruitment by participating in candidate screening and interviews for quality-related roles.

Required Skills & Qualifications:

• Strong communication skills with a neutral accent.
• Excellent written and verbal English communication.
• Willingness to work in US shift timings.
• Strong stakeholder management and client-facing experience.
• Ability to collaborate across departments with a One Team approach.
• Good knowledge of US Healthcare RCM processes.
• Experience in quality management, audits, RCA, and process improvement.
• Lean Six Sigma certification (preferred).