About FlyteHealth

FlyteHealth is a cardio-kidney-metabolic care provider transforming how obesity, prediabetes, hypertension, and hyperlipidemia are treated. Our model combines behavioral lifestyle change, virtual clinical care, remote monitoring, and a multidisciplinary care team. We partner with employers, payors and PBMs, health systems, consultants, and care navigators to expand access and deliver measurable outcomes.

The opportunity:

We are seeking a hands-on builder-operator to own and scale FlyteHealth's RCM function and payor operations. This leader will ensure accurate, timely, and predictable cash; launch case-rate and Medicare / Medicare Advantage billing; and own operational relationships with payor partners. Reporting to the CFO, this remote leader will set strategy, manage the team and vendors, and personally drive claim- and contract-level resolution. The role partners closely with Clinical Operations, MSO, Legal, and Compliance to align care delivery, documentation, contracts, systems, and billing.

What you will own:

Lead and scale end-to-end revenue cycle management

• Own end-to-end performance across eligibility, charge capture, coding, claim submission and adjudication, payment posting, denials and appeals, AR, patient collections, and cash reconciliation across FlyteHealth's professional entities.
• Work directly with payors to resolve rejected, denied, underpaid, or incorrectly adjudicated claims; identify and correct root causes in documentation, coding, eligibility, workflow, system configuration, or contract terms.
• Set the RCM strategy, controls, service levels, metrics, and operating cadence; deliver reliable reporting and forecasting across clean claims, denials, days in AR, collections, underpayments, cost to collect, and cash.
• Own team, vendor, and platform performance across AthenaOne, clearinghouses, payor portals, Evolve, and analytics; drive configuration, QA, automation, and build, buy, or in-house decisions.
• Coordinate payor, coding, and documentation audits and corrective action plans with Compliance, Finance, Legal, Clinical, and MSO; maintain compliant, audit-ready policies and operations.

Build new reimbursement capabilities

• Design and implement case-rate billing, including eligibility and enrollment rules, episode logic, fee schedules, claims or invoices, contract configuration, reconciliation, reporting, and exception management.
• Build Medicare, Medicare Advantage, Medicaid, and population-health readiness across enrollment, eligibility, documentation, CPT / HCPCS and CPT II, quality codes, modifiers, supplemental coding, claims, remittance, secondary billing, and payor-specific policies.
• Create a repeatable launch playbook for new payors, partners, markets, products, and reimbursement models, with clear gates across contracting, credentialing, clinical workflows, systems, data, billing, and member communications.
• Translate fee-for-service, case-rate, bundled, and value-based contracts into executable workflows and reliable financial reporting.

Own operational relationships with payors

• Serve as the senior operational relationship lead for national and regional health plans, PBMs, TPAs, and other reimbursement partners across Commercial, Medicare Advantage, and Medicaid.
• Maintain relationships with payor claims, provider-relations, network, coding, and reimbursement teams; use an established network to clarify requirements proactively, reach decision-makers, and accelerate resolution.
• Establish a disciplined payor-management cadence with performance reviews, escalation paths, issue logs, reimbursement monitoring, and commitments tracked through resolution.
• Partner with leadership, Finance, Legal, and Business Development on contract strategy and negotiations; own operational feasibility, implementation, and ongoing performance.

Lead the function and enable the organization

• Lead and scale the RCM team, clarify roles, raise the operating bar, and build a culture of ownership, accuracy, urgency, and continuous improvement.
• Create training and feedback loops for clinicians and operations teams on documentation, coding, authorization, and other upstream drivers of reimbursement.
• Serve as the bridge across Clinical, Finance, Compliance, Legal, and MSO, translating payor requirements into workflows that are clinically appropriate, compliant, and financially sustainable.
• Advise the CFO and leadership team on reimbursement risk, payor performance, cash outlook, capacity, investment priorities, and clinical, product, and market-expansion decisions.

What success looks like:

• Diagnose and prioritize. Within 90 days, establish a fact-based view of RCM performance, revenue leakage, team and vendor capabilities, payor issues, and remediation priorities.
• Build control and improve economics. Establish reliable KPI and cash forecasting, then reduce preventable denials, underpayments, aged AR, and cycle time while improving collections and predictability.
• Launch new capabilities. Deliver the operating infrastructure for case-rate billing and Medicare / Medicare Advantage in line with FlyteHealth's growth roadmap.
• Strengthen and scale. Build durable payor relationships, a high-performing team, and an operating model that supports growth without adding headcount linearly.

Required experience:

• 7+ years of progressive healthcare RCM, reimbursement, or payor operations experience, including 3+ years leading a team, function, or major transformation.
• End-to-end ownership of professional billing, with the depth to diagnose issues from documentation and eligibility through claims, adjudication, remittance, denials, AR, and reconciliation.
• A record of building or materially scaling RCM in a startup, growth-stage digital health company, or similarly fast-changing care-delivery organization.
• Direct experience implementing Medicare / Medicare Advantage billing and at least one non-standard model such as case rates, bundled payments, or value-based contracts.
• Strong relationships across national and regional health plans, with evidence of using them to navigate organizations, resolve problems, and advance shared priorities.
• Strong command of CPT / HCPCS and CPT II, ICD-10, modifiers, quality and supplemental coding, payor rules, EHR / practice-management systems, clearinghouses, and RCM analytics.
• Analytical and financial fluency, plus the judgment to balance reimbursement economics, compliance, clinician workflow, and patient experience.

Preferred experience:

• Experience in a multi-state virtual-care, medical-group, or MSO / affiliated professional-entity model.
• Experience with credentialing and enrollment, delegated arrangements, risk adjustment, Medicaid, secondary billing, or new-market / new-payor launches.
• Experience with AthenaOne or a comparable RCM platform, automation or AI-enabled workflows, and relevant credentials such as CPC, CCS, CRCR, CRCS, or HFMA certification.

FlyteHealth Benefits:

• Comprehensive health, dental, and vision insurance
• Discretionary PTO Plan
• Parental leave

FlyteHealth Perks:

• Flexible working hours
• Remote-first company
• Stipend for remote working
• Paid company holidays

FlyteHealth values diversity and is committed to equal opportunity for all, regardless of race, religion, color, creed, marital status, age, national origin, physical disability, medical condition, sexual orientation, or gender identity.