Director, Software Engineering - Financial Solutions

Job Summary:

The Director of Software Engineering – Financial Solutions will lead the design, development, and optimization of software systems that streamline and automate claims management, reconciliation, healthcare billing, contracting, and audits. This role is responsible for building robust and scalable platforms that ensure efficient, compliant, and secure management of the healthcare revenue cycle. The director will work closely with cross-functional teams to ensure the software solutions address the complex challenges of healthcare finance, while adhering to industry standards and regulations.

Key Responsibilities:

• Strategic Leadership (30%):

  • Develop and implement a software engineering strategy focused on optimizing healthcare revenue cycle processes, including claims submission, payment processing, collections, and contracting.

  • Lead and mentor a team of software engineers to deliver innovative solutions that drive efficiency, accuracy, and compliance in RCM operations.

  • Work closely with customer service, operations, and product teams to align RCM software solutions with business goals, focusing on reducing denials, improving cash flow, and minimizing manual workflows.

• Software Development & Architecture (20%):

  • Architect, develop, and manage RCM platforms that automate patient billing, claims and payment reconciliation processes.

  • Oversee the integration of RCM systems with Electronic Health Records (EHR) and Practice Management Systems (PMS), ensuring seamless data flow across platforms.

  • Implement advanced analytics and reporting capabilities to provide real-time insights into the revenue cycle, helping to identify bottlenecks and optimize performance.

• Healthcare Compliance & Regulatory Adherence (20%):

  • Ensure all RCM software solutions comply with healthcare regulations, including HIPAA, ICD-10, CPT, and other industry standards related to billing and coding.

  • Implement secure data handling and storage practices to protect sensitive patient financial information, adhering to privacy regulations and cybersecurity best practices.

  • Lead initiatives to ensure compliance with payer-specific requirements and healthcare financial regulations, including Medicare, Medicaid, and private insurers.

• Collaboration with Cross-Functional Teams (20%):

  • Collaborate with finance, billing, and clinical teams to gather requirements, define priorities, and ensure RCM systems meet operational needs.

  • Partner with external vendors and clearinghouses to streamline claims submission and payment processes, ensuring seamless integration with third-party systems.

  • Work closely with data engineering and analytics teams to develop reporting tools that provide actionable insights into the revenue cycle, helping to reduce denials and improve financial outcomes.

• Innovation & Continuous Improvement (20%):

  • Stay at the forefront of emerging technologies and trends in revenue cycle management, healthcare billing, and claims processing.

  • Drive continuous improvement in RCM processes through the adoption of automation, AI, and machine learning tools to enhance billing accuracy, reduce denials, and accelerate payment cycles.

  • Implement agile methodologies and DevOps practices to ensure rapid delivery of high-quality, scalable software solutions.

Qualifications:

• Bachelor’s degree in Computer Science, Software Engineering, or a related field. A Master’s degree is preferred.

• 8+ years of experience in software engineering, with at least 3+ years of experience in healthcare revenue cycle management or financial systems.

• Proven track record of leading software engineering teams in building scalable, high-performance RCM or financial platforms.

• In-depth knowledge of healthcare billing, coding, and claims management processes, including payer requirements, denial management, and regulatory compliance.

• Experience with cloud platforms (e.g., Google, Azure, AWS), microservices architecture, APIs, and EHR/PMS integration.

• Strong knowledge of software security, data privacy, and healthcare regulations (e.g., HIPAA, ICD-10, CPT, CMS regulations).

• Excellent leadership, problem-solving, and communication skills, with the ability to influence cross-functional teams and stakeholders.

Preferred Skills:

• Good understanding of basic accounting principles, general ledger accounting, and double-entry bookkeeping.

• Experience with revenue cycle analytics and business intelligence tools.

• Familiarity with AI/ML applications for predictive billing, denial management, and claims processing.

• Experience with third-party clearinghouses, payers, and healthcare financial institutions.

We are an Equal Opportunity Employer, including disability/vets.