Director of CCM/RPM Operations
Owns the end-to-end operational backbone of CCM and RPM programs across multiple physician practices — covering billing, compliance, reporting, and account management.
Sector
Healthcare Operations — Chronic Care Management & Remote Patient Monitoring
Reports to
Senior Leadership
Type
1099 Independent Contractor (with potential conversion to W-2)
Hours
Full-time · US Central / Eastern business hours (Texas-based preferred)
Location
Remote · Must overlap with US Central/Eastern time zones
Tools
Akos, HealthSnap, Prevounce, Optimize Health (familiarity helpful); standard billing and reporting tools
Role Overview
Our client is seeking a Director of CCM/RPM Operations to lead and own the full operational infrastructure of their care management programs. This is a high-impact, builder-stage role responsible for billing performance, CMS compliance, reporting infrastructure, and practice-level account management across multiple physician groups.
The successful hire will be someone who designs systems, solves operational problems, and scales what works — not just an operator who manages existing workflows. This role sits at the intersection of clinical care, revenue, compliance, and practice relationships.
Key Responsibilities
Billing & Revenue Cycle
- Own CCM/RPM billing performance and integrity across all partner practices
- Ensure documentation supports billing requirements; monitor claim accuracy and reduce denial rates
- Work with internal teams and external billing partners to improve collections and streamline processes
- Define workflows for complex billing scenarios: straddle-month billing, corrections, and audit documentation
Compliance & Audit Readiness
- Ensure all programs adhere to CMS guidelines for CCM, RPM, PCM, and TCM — including supervision requirements and documentation standards
- Build and maintain audit-ready workflows at all times
- Lead internal audits and prepare for external audits
- Translate regulatory updates into operational changes
Program Operations & Performance
- Oversee operational performance across practices; define and track key metrics (enrollment growth, engagement, billable utilization, device compliance)
- Identify bottlenecks and implement process improvements
- Ensure alignment between clinical workflows, platform capabilities, and billing requirements
Reporting & Analytics
- Build and manage reporting across operational, financial, and practice-level performance
- Develop dashboards, ensure data accuracy, and translate insights into actionable recommendations
- Support billing validation, compliance monitoring, and executive decision-making
Account Management & Practice Success
- Serve as senior operational point of contact for physician practices
- Support onboarding, monitor performance, and identify growth opportunities
- Build strong relationships with physicians and practice administrators
Cross-Functional Leadership
- Collaborate with clinical leadership, care management teams, and product/technology partners
- Design systems that scale as the organization grows
Who Will Succeed in This Role
The right candidate brings deep CCM/RPM expertise combined with a high ownership mindset and comfort operating in a fast-moving build-stage environment. They design systems, fix what's broken, and scale what works — without needing a fully defined playbook to get started.
- High ownership orientation — treats the programs as if they personally built them
- Comfortable operating with ambiguity; builds structure where none exists
- Detail-oriented without losing sight of the bigger operational picture
- Strong communicator who can work directly with physicians and practice administrators
- Analytically strong — turns data into decisions, not just reports
Experience & Skills
Required:
- 7–10+ years in healthcare operations with direct CCM and/or RPM program experience
- Strong background in revenue cycle management, Medicare Part B billing, and care management operations
- Deep knowledge of CCM/RPM CPT codes: 99490, 99439, 99487, 99489, 99453, 99454, 99457, 99458
- Fluency with documentation requirements, time-based billing rules, and supervision models
- Experience working with physician practices; cardiology, MSO, CIN, or VBC background preferred
- Prior experience leading programs or teams
- AI fluency — actively uses AI tools to work faster and smarter; must be able to speak to specific tools and use cases at screening
- Strong written and verbal communication — exceptional written English; assessed at screening
- Must be able to work during US Central/Eastern business hours
Preferred:
- Experience in cardiology or with cardiac patient populations
- Hands-on experience with RPM device programs
- Familiarity with Akos, HealthSnap, Prevounce, or Optimize Health
- Value-based care or ACO model experience
- Clinical background (RN, NP, or similar) — beneficial but not required