Director, RCM Revenue and Reserve Accounting

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Role Overview

The Director, RCM Revenue and Reserve Accounting provides strategic and hands-on financial leadership for The US Oncology Network’s practice discount and accounts receivable reserve processes. Reporting to the Senior Director, Revenue Cycle Management Finance, this role serves as the senior Accounting subject matter expert for iReserve methodology, contractual allowances, bad debt, denials, AR aging, reserve governance, and the resulting balance sheet and income statement impacts for the practices. The Director leads review and interpretation of reserve performance across practices, resolves complex or nonstandard financial questions, and establishes consistent, supportable processes and controls.

The Director partners closely with Practice Finance, Accounting, Controllership, Revenue Cycle Operations, Finance Systems, and data and analytics teams to investigate material variances, translate reserve mechanics into clear business implications, and recommend appropriate financial action. The role combines meaningful direct execution with team leadership, including ownership of SOX controls, prioritization of recurring close and practice-support activities, development of scalable tools and documentation, and coaching of the RCM Revenue and Reserve Accounting team.

Key Responsibilities

Subject Matter Expertise for Practice Discount Reserve Processes

• Serve as the senior subject matter expert for practice discount and patient AR reserve processes, including iReserve methodology, contractual allowances, bad debt, denials, AR aging, and the resulting balance sheet and income statement impacts; provide guidance on complex or unusual reserve matters and translate reserve mechanics into clear financial implications for practice and Network leadership

• Lead review and interpretation of reserve results across practices, including balance sheet-to-iReserve comparisons, historical and current discount-rate trends, AR aging, manual accruals and other drivers of reserve variability; identify outliers and coordinate root-cause analysis and appropriate financial treatment

• Establish and continuously improve reserve methodologies, monitoring, and governance for revenue cycle processes

Business Partnership with Practice Finance Teams

• Serve as a strategic partner to Practice Controllers, Regional Finance Directors, practice leadership, and Revenue Cycle stakeholders, helping teams understand reserve and discount performance, investigate material variances, and determine appropriate actions when financial results diverge from expectations

• Lead practice-level financial discussions on AR and reserve matters, translating complex reserve methodology, collectability assessments, AR aging, and alternative financial treatments into clear implications for practice economics and decision-making

• Partner cross-functionally with Practice Finance, Accounting, Revenue Cycle, Controllership, and data and technology teams to investigate issues, align financial and operational information, and develop supportable recommendations that balance accounting requirements with the underlying operations

Sarbanes-Oxley Control Ownership

• Own and oversee RCM Finance SOX controls associated with patient AR reserves and financial discount processes, including control documentation, execution, evidence, issue identification, and remediation; ensure processes remain supportable as business requirements, systems, and reserve methodologies evolve

• Maintain disciplined documentation and review standards around system flows and reserve calculations

• Partner with Accounting, Controllership, Finance Systems, Internal Audit, and other stakeholders to identify control risks arising from changes in reserve logic, data flows, mappings or manual processes and drive sustainable processes

Team Management and Prioritization

• Lead and develop the RCM Revenue and Reserve Accounting team, establishing priorities, accountability, review standards, and a scalable operating model while building broader subject-matter expertise across iReserve, discount reserves, controls, and practice support

• Direct and prioritize team resources across recurring close responsibilities, practice support, troubleshooting, SOX requirements, and emerging financial issues, ensuring material matters receive timely analysis, escalation, and resolution

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