Associate Director - Solutions - REF108323C_2026270472 - Healthcare

Role: Revenue Cycle Management (RCM) Product Consulting Position Summary : We are looking for a highly skilled professional to join as a Techno-Functional Expert in the field of RCM. This role will serve as a critical bridge between business stakeholders, domain experts, and technology teams and will contribute to the development of a next-generation RCM platform integrating outcome-driven automation and AI-powered capabilities, including but not limited to claims automation, autonomous coding, collections, analytics and denials management. The ideal candidate brings deep field-level knowledge of revenue cycle workflows and is adept at translating operational pain points into technical requirements for innovative, scalable solutions. Key Responsibilities Business Analysis & Requirements Gathering • Engage with RCM stakeholders (operations, compliance, technology) to gather and document detailed business requirements across intake, coding, billing, claims, A/R, and denials. • Define user stories, business rules, data flows, and system behavior aligned with operational outcomes. • Work closely with product managers to prioritize features based on business value and technical feasibility. • Partner with sales and account teams to shape solutions for new opportunities, contributing to solution design, proposals, due diligence, and client presentations.  Subject Matter Expertise (SME) • Provide domain expertise in U.S. healthcare revenue cycle processes and technologies. • Offer field-level insights from front-end intake through back-end collections and appeals. • Advise on industry best practices, compliance considerations, and emerging trends in automation and AI adoption in RCM.  Techno-Functional Collaboration • Act as a liaison between business users and development teams to ensure solution design aligns with functional needs. • Partner with architects and engineers on data modeling, workflow engines, and AI/ML model integration. • Participate in user acceptance testing (UAT), validating system outputs against business expectations.  Platform Innovation • Contribute to platform design and modularization of features such as (but not limited to) o Claims Automation (e.g., OCR, NLP, intelligent form capture) o Autonomous Coding (ICD/CPT code prediction using AI/ML) o Process Optimization (clearinghouse logic, eligibility validation) o Denials Prevention & Prediction (ML-based denial scoring, root cause analytics) • Identify opportunities for AI/automation to enhance accuracy, reduce TAT, and minimize human intervention. • Documentation & Change Management • Develop clear documentation including BRDs, FRDs, process maps, and data dictionaries. • Support training, change management, and knowledge transfer to internal teams and client stakeholders.