Hybrid Director Of Clinical Revenue Cycle

The Director of Clinical Revenue Cycle provides operational oversight, strategic planning, and execution for all areas of the Clinical Revenue Cycle. This role is responsible for planning, organizing, coordinating, managing, implementing, evaluating, and developing functions including Utilization Review, Clinical Appeals, Charge Description Master (CDM) Management, and Revenue Integrity . The Director serves as a critical liaison between clinical and non‑clinical departments to ensure accurate reimbursement and positive financial outcomes that align with the care delivered to patients. This position guides and directs the utilization team to optimize financial performance, ensure appropriate utilization of resources, and support coordination of care across the continuum. The Director functions as the internal subject matter expert on utilization management and clinical revenue cycle operations.

Essential Duties And Responsibilities

• Provide direct supervision and leadership for Utilization Review, Revenue Integrity, and CDM Management teams
• Evaluate staff performance and productivity to ensure effective and efficient use of resources
• Direct and oversee all Utilization Review activities, implementing efficiency and quality improvement initiatives
• Develop, monitor, and achieve departmental goals aligned with organizational performance metrics
• Conduct random audits to ensure appropriateness, accuracy, and timeliness of Utilization Review activities
• Monitor documentation within software platforms for compliance and appropriate utilization
• Collaborate closely with peers and leadership to ensure timely resolution of operational and financial issues
• Maintain, analyze, and report data and metrics for the Revenue Cycle Committee
• Prepare and submit required reports to the Utilization Management Committee
• Annually review and revise Utilization Review plans and submit for approval to the Utilization Committee and Medical Executive Committee
• Assist with development and oversight of the departmental budget and ensure operations remain within allocated funds
• Manage and oversee all payer appeals related to denials
• Implement strategies to reduce denials while optimizing revenue capture
• Ensure hospitalized patients are assigned the correct admission status for accurate claim submission
• Oversee and coordinate the development of the Utilization Review program and required hospital resources
• Foster staff and physician engagement in revenue cycle and utilization management processes
• Lead continuous process improvement initiatives to maximize financial and operational performance
• Communicate Utilization Review outcomes and trends through appropriate committees and leadership forums
  
  
  

Supervisory Responsibilities

• Supervises: Utilization Review RNs, Revenue Integrity team, CDM Management team
  
  
  

Minimum Qualifications

Education & Experience Requirements

• Bachelor’s degree in healthcare administration, nursing, health informatics, business, or related field
• Five (5) years of management experience may be considered in lieu of a degree
• Three (3) years of direct patient care experience as an RN in an acute care environment
• Five (5) years of experience in Utilization Review or Case Management, including at least two (2) years in an acute care setting
• Experience with Epic EMR (required)
  
  

Preferred Qualifications

• Master’s degree
• Certified Professional Coder (CPC)
• Certified Case Manager (CCM) or Accredited Case Manager (ACM) within two (2) years of eligibility
  
  
  

Licenses & Certifications

• If degree is in Nursing, active RN license is required
  
  
  

Job Type & Location

This is a Permanent position based out of Chesapeake, VA.

Pay And Benefits

The pay range for this position is $100000.00 - $130000.00/yr.

Benefits & Perks Chesapeake Regional Healthcare offers a comprehensive and competitive benefits package designed to support employees’ health, financial wellness, and work‑life balance, including: Medical, Dental & Vision Coverage Multiple medical plan options through Aetna, including HSA‑eligible plans Tiered provider network with lower out‑of‑pocket costs for CRH providers Prescription drug coverage and access to CRH pharmacy services Comprehensive dental and vision plans Health & Wellness Programs On‑site Quick Care Clinic and virtual care options Employee‑only GLP‑1 Weight Loss Management Program (for eligible participants) Smoking cessation, chronic disease management, and fitness programs On‑site fitness center and wellness incentives through the HEALTHYme program Financial & Retirement Benefits Retirement savings plans with employer match and vesting Employer‑funded Health Savings Account (HSA) contributions (for eligible plans) Financial wellness coaching and planning resources through UBS Flexible Spending Accounts (Healthcare and Dependent Care) Paid Time Off & Leave Generous Paid Annual Leave (PAL) with rollover options Observed paid holidays Short‑ and long‑term disability coverage (employer‑paid for eligible roles) Life & Income Protection Employer‑paid life insurance and AD&D coverage Optional voluntary life insurance for employees and dependents Additional Voluntary Benefits Employee Assistance Program (EAP) with confidential counseling and legal/financial support Critical illness, accident, and hospital indemnity plans Identity theft protection, legal resources, and pet insurance

Workplace Type

This is a hybrid position in Chesapeake,VA.

Application Deadline

This position is anticipated to close on May 1, 2026.

h4>About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems And TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.