Job Description
Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts’ comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients. Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions. As one of the largest EHR companies in the country, Qualifacts offers revolutionary support for behavioral health, human services, and rehabilitative services. The technology and solutions that we provide enhance how our customers deliver quality care, make it possible for them to achieve exceptional outcomes, and improve the lives of the individuals they serve. We draw upon 20 years of experience to inform our products and services, and the result is solutions that empower our customers to achieve interoperability goals, optimize efficiency, improve productivity, and maximize reimbursement. Qualifacts supports three platforms: CareLogic, Credible, and InSync. The EHR platforms, each uniquely positioned, allow us to serve all segment sizes within the market. If you want to work inside an atmosphere where innovation has purpose, and your ambition works to support our customers and those they serve, please apply today This is an onsite position, 5 days/week, in the Vadodara office working the NIGHT SHIFT. Hours are 6:30pm-3:30am IST. Remote applicants will not be considered. Why Join Us?
• Opportunity to work on cutting-edge projects.
• Collaborative and growth-oriented work environment.
• Competitive salary and benefits. Responsibilities for the Senior Manager, RCMS India Operations Operational Leadership and Service Delivery
• Lead assigned end-to-end RCM operations across charge capture, billing, prior authorization, payment posting, A/R follow-up, denial prevention and resolution, collections, credit balances, and related functions.
• Translate Director-approved strategy into annual and quarterly operating plans, staffing and capacity models, performance goals, workflows, controls, and manager-level accountabilities.
• Establish a rigorous daily, weekly, and monthly operating cadence that identifies variance early, assigns ownership, removes barriers, and confirms sustained corrective action.
• Balance work across teams and shifts using demand, inventory, complexity, quality, productivity, and service-level data; make timely resource decisions within approved budgets and plans.
• Maintain business continuity, cross-training, succession coverage, and contingency plans for critical processes, client commitments, and leadership roles. Performance Management, Analytics, and Financial Outcomes
• Own portfolio-level performance visibility for assigned scope and ensure one reliable view of SLAs, KPIs, backlog, quality, clean claim rate, denial rate, days in A/R, aging, collections, turnaround time, capacity, and cost-to-serve.
• Lead fact-based root-cause analysis that distinguishes client, payer, front-end, back-end, technology, training, and control drivers; require corrective and preventive actions with owners, due dates, benefit measures, and validation of sustained results.
• Identify revenue leakage, underpayments, recurring denials, avoidable rework, workflow bottlenecks, and productivity loss; prioritize interventions based on client, financial, compliance, and operational impact.
• Build manager capability in forecasting, variance analysis, staffing economics, productivity standards, and value realization; provide the Director with concise insights, scenarios, and recommendations rather than activity reporting.
• Support budget planning and manage assigned labor, overtime, vendor, and operating expenses within approved targets. Client, Stakeholder, and Escalation Leadership




• Serve as the senior India operations contact for assigned US-based clients and internal partners; lead operational reviews and contribute to executive business reviews with clear performance narratives and action plans.
• Lead complex service recovery and escalation management by establishing facts, stabilizing delivery, communicating transparently, coordinating cross-functional action, and confirming that corrective actions prevent recurrence.
• Build effective partnerships with US operations, customer relationship teams, onboarding, finance, technology, analytics, compliance, human resources, training, and quality to deliver integrated client outcomes.
• Represent India operations in approved governance forums and ensure decisions, commitments, risks, and dependencies are documented and closed on time.
• Contribute operational expertise to proposals, scope changes, client growth opportunities, and value analyses when requested. People Leadership and Organizational Capability
• Lead through managers, supervisors, team leads, and subject-matter experts; set clear outcomes, decision rights, and behavioral expectations at each leadership layer.
• Create a high-performance environment through regular coaching, differentiated development, timely feedback, recognition, accountability, and decisive management of performance gaps.
• Build a strong leadership bench through succession planning, talent reviews, readiness plans, stretch assignments, mentoring, and cross-functional exposure.
• Partner with human resources and recruiting on workforce plans, hiring profiles, selection quality, onboarding, engagement, retention, attendance, and leadership continuity.
• Partner with training and quality teams to maintain role-based curricula, certification pathways, proficiency validation, nesting support, and remediation tied to operational outcomes.
• Promote an inclusive, ethical, client-centered culture that encourages constructive challenge, learning, knowledge sharing, and ownership. Quality, Compliance, and Operational Controls
• Ensure compliance with HIPAA, CMS requirements, payer rules, client policies, information-security standards, and applicable company controls across assigned operations.
• Maintain audit readiness through current SOPs, access controls, quality assurance, calibration, documentation, issue tracking, and timely remediation of findings.
• Embed quality at the source by using error taxonomy, control points, sampling, coaching, and trend analysis to reduce defects and rework.
• Escalate suspected privacy, security, compliance, fraud, or material control issues immediately and preserve accurate documentation for investigation and remediation. Transformation, Scalability, and Growth Enablement
• Lead implementation of approved process, technology, analytics, automation, RPA, AI-enabled workflow, and operating-model changes; ensure adoption, control effectiveness, and measurable benefits.
• Use process mapping, standard work, Lean problem solving, and change-management practices to simplify work, reduce variation, and improve throughput and client value.
• Support recent-client transitions, scope expansions, migrations, and stabilization by confirming operational readiness, staffing, training, controls, acceptance criteria, and post-go-live governance.
• Identify opportunities to standardize and scale delivery across clients while preserving contractual, specialty, payer, and regulatory requirements.
• Pilot new capabilities within agreed guardrails, document lessons learned, and recommend broader adoption to the Director. Qualifications of the Senior Manager, RCMS India Operations
• Bachelor's degree in Business Administration, Healthcare Management, Finance, Commerce, or a related field; master's degree preferred.
• Typically 10 or more years of progressive experience in US healthcare RCM or healthcare services operations, including at least 3 years leading managers and large, multi-layered teams in a shared-services, BPO, KPO, or technology-enabled services environment.
• Demonstrated command of behavioral health, physician and/or facility billing, A/R follow-up, denial prevention and appeals, payment posting, prior authorization, collections, payer processes, and revenue integrity.
• Proven success improving service delivery,



financial outcomes, client experience, quality, productivity, workforce performance, and operating controls across multiple clients or service lines.
• Experience leading complex escalations, transitions, transformation initiatives, and cross-functional problem-solving with US-based stakeholders.
• Strong working knowledge of CPT, ICD-10-CM, HCPCS, Medicare, Medicaid, commercial payer requirements, HIPAA, CMS guidance, and associated RCM controls.
• Experience with EHR and RCM platforms such as Qualifacts, Epic, Oracle Health/Cerner, athenahealth, or NextGen, together with advanced reporting, workforce, workflow, and automation tools.
• Advanced proficiency with Excel and performance reporting; experience with Power BI or comparable analytics tools preferred.
• Ability to support US business hours, client meetings, rotational coverage, and limited travel as business needs require. Knowledge, Skills, and Abilities
• Operational leadership: Builds management systems that convert priorities into reliable execution across multiple teams, clients, and workstreams.
• RCM technical depth: Connects coding, billing, payer, reimbursement, clinical documentation, authorization, denial, payment, and collection drivers across the revenue cycle.
• Analytical problem solving: Uses structured root-cause analysis, financial and operational data, trend analysis, and hypothesis testing to reach defensible conclusions and durable solutions.
• Business and financial acumen: Understands revenue, cash, margin, cost-to-serve, staffing economics, productivity, contractual commitments, and the trade-offs among service, quality, growth, and cost.
• Leadership through leaders: Sets explicit decision rights, coaches managers, builds succession depth, and creates accountability without becoming the operational bottleneck.
• Client and executive communication: Presents complex performance, risk, and recommendations with clarity, confidence, and appropriate detail for clients and senior leaders.
• Change leadership: Creates a practical case for change, anticipates stakeholder impact, manages resistance, reinforces adoption, and verifies benefit realization.
• Influence and collaboration: Aligns global and cross-functional partners, resolves competing priorities constructively, and advances enterprise outcomes beyond the immediate function.
• Risk and control judgment: Recognizes material operational, client, privacy, security, regulatory, and financial risk and acts within established escalation requirements.
• Digital fluency: Applies dashboards, workflow tools, automation, RPA, and AI responsibly to improve control, colleague productivity, and client outcomes.
• Preferred certifications include CRCR, CRCE, CPC, Lean Six Sigma, PMP, or equivalent healthcare, process-improvement, or program-management credential. Key Performance Indicators
• Service reliability: Achievement of client-specific SLAs and KPIs, including backlog, turnaround, response time, and delivery commitments.
• Quality and compliance: Accuracy, audit outcomes, defect and rework trends, control completion, remediation timeliness, and absence of preventable material compliance failures.
• Revenue cycle outcomes: Clean claim performance, denial prevention and resolution, days in A/R, aged receivables, collections, underpayment recovery, and revenue leakage reduction within assigned scope.
• Productivity and capacity: Attainment of approved production and utilization standards while protecting quality, schedule adherence, employee sustainability, and service continuity.
• Client

experience:
Stability of assigned accounts, timely closure of commitments, escalation recovery, operational credibility, and agreed satisfaction measures.
• People and leadership: Manager effectiveness, retention, engagement, attendance, performance-management completion, succession coverage, proficiency, and training or certification completion.
• Continuous improvement and transformation: Delivery and sustained adoption of approved improvements, automation, and cost-efficiency initiatives with documented benefits.
• Financial stewardship: Performance against approved staffing and operating plans, forecast accuracy, overtime control, and measurable improvement in cost-to-serve or capacity.
• Perform other duties and lead special projects as assigned by the Director, RCMS India Operations. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

📌 Senior Manager, RCMS Operations (Vadodara)
🏢 Qualifacts
📍 Vadodara