Jobs at R1 RCM

Serve as a centralized HR contact managing employee relations, case intake, performance management, disciplinary actions, termination risk reviews, leave and ADA accommodation processes, and coach leaders to ensure legally defensible, consistent outcomes across a nationwide employee population.

Design, develop, and maintain Snowflake-backed semantic models and Power BI reports; build SQL queries, functions, and stored procedures; use AI-assisted tooling (Claude, MCP) to accelerate BI development; manage work in Azure DevOps, version control with GitHub; ensure QA, documentation, stakeholder communication, and mentor fellow developers.

Verify and load platform-discovered patient insurance coverage into R1 and client systems to improve billing accuracy and recovery. Manage coverage work queue, research eligibility, coordinate with payers and provider teams, update patient records, follow client SOPs, maintain HIPAA compliance, support reporting/metrics, recommend improvements, and train/liaise between clients and internal teams.

Serve as a subject-matter Business Analyst for Insurance Discovery: analyze client data, validate ingestion and reporting, produce BI reports, translate client requirements into technical specs, create SOPs and audit scripts, support legacy systems through decommissioning, and collaborate cross-functionally to improve revenue cycle performance and client satisfaction.

The Physician Advisor reviews denied authorization cases, evaluates documentation, advises on request appropriateness, and engages with payor medical directors, serving as a clinical resource for staff.

As a Senior Product Manager, you will oversee AI analytics product development, prioritize initiatives, communicate with stakeholders, and manage the product roadmap while ensuring timely delivery of features and aligning them with business strategies.

The Forward Deployed Process Consultant will bridge executive strategy with operational execution in healthcare, focusing on process optimization and stakeholder communication. Responsibilities include translating business requirements, collaborating on solutions, and monitoring performance metrics.

Lead commercial product enablement for PhareOS by turning complex AI-native capabilities into clear buyer narratives, defining demo strategy, supporting strategic deals, and building scalable enablement programs and materials across Sales, Product, Client Delivery, and Marketing.

Investigate, document, and remediate data incidents and privacy issues; support HIPAA and other privacy compliance activities, risk assessments, metrics/reporting, staff education, and cross-functional remediation to protect PHI and improve privacy controls.

Generate qualified inbound and outbound leads for the outside sales team, prospecting healthcare organizations, managing a pipeline, engaging decision-makers, qualifying and nurturing prospects, and coordinating handoffs to sales using CRM and outreach tools to drive pipeline growth.

The Manager, Complex Claims leads operations for complex claims teams, drives operational excellence, improves processes, and coaches team members to achieve performance goals.

Translate operational requirements into solution designs, process maps, and implementation plans. Conduct current-state assessments, support implementation and stabilization, define KPIs/SLAs, manage stakeholder communications, change management, and risk/issue mitigation while partnering with process engineers and cross-functional teams.

Translate business requirements into implementation artifacts, document current and future-state workflows, and support end-to-end delivery of use cases. Assist with implementation plans, stakeholder communications, training, change management, go-live stabilization, KPI/SLA tracking, and post-implementation reviews. Maintain trackers, issue logs, and support continuous improvement. Role may require extensive travel to client sites.

Design and optimize consulting delivery processes, quantify use case ROI, lead and mentor consultants, develop roadmaps and change management, provide technical/product leadership, monitor KPIs/SLAs, and ensure continuous improvement. Role requires frequent customer engagement and significant travel (50%+).

Analyze denied claims to identify clinical, coding, and process root causes; write clear problem statements; quantify financial impact; partner with coding and revenue cycle teams to recommend and drive corrective actions to reduce preventable denials.

As a Coding Integrity Specialist, you will conduct coding reviews, ensure proper reimbursement, collaborate with teams, and provide feedback on coding accuracy.

The RVP of Sales will drive revenue growth through client acquisition and expansion by executing strategies, forecasting sales, and collaborating with internal teams.

Conduct concurrent and retrospective reviews of inpatient records to improve clinical documentation and coding accuracy. Query physicians, assign working DRGs, perform mortality and PSI reviews, educate providers and CDI staff, collaborate with coders and quality teams, and assist onboarding/training of new CDI members.

As a Complex Denials Consultant, you will counsel healthcare providers in disputes with insurance carriers, handle appeals, and ensure compliance with regulations.

Lead setup and QA of client revenue-cycle data feeds, load and validate data, create standardized and ad-hoc reports, analyze results for operations and leadership, maintain health information system data models, implement data validation standards, and drive process improvements to accelerate implementations and improve data quality.