Director of CCM/RPM Operations

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. About Cardiac Care Alliance (CCA) Cardiac Care Alliance (CCA) is building a next-generation, cardiology-focused care management platform that supports both fee-for-service and value-based programs across Chronic Care Management (CCM) and Remote Patient Monitoring (RPM). We partner with physician practices to extend care beyond the clinic, helping patients stay connected, supported, and engaged in managing their heart health. At the same time, we bring operational discipline to billing, compliance, and reporting – ensuring programs are not only clinically effective, but also financially and operationally sound. About the Role We are looking for a Director of CCM/RPM Operations to lead and own the operational backbone of our programs. This is a high-impact role responsible for the end-to-end performance of CCM and RPM across multiple practices. You will oversee billing operations, ensure compliance with CMS regulations, build reporting infrastructure, and serve as a key operational & implementation partner to physician groups. You will play a central role in making sure our programs are structured for growth while remaining audit-ready, efficient, and aligned with real-world clinical workflows. This role is ideal for someone who is not just an operator, but a builder – someone who can design systems, fix what's broken, and scale what works. 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 Fluency with documentation requirements, time-based billing rules, and supervision models Experience working with physician practices; 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 Deep knowledge of CCM/RPM CPT codes: 99490, 99439, 99487, 99489, 99453, 99454, 99457, 99458 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 Location: Remote (Texas-based, preferred) Company: Cardiac Care Alliance (CCA) Compensation: $110-120K/yr. Type: W-2. Benefits will likely be offered.