Revenue Cycle Program Manager

Title: Revenue Cycle Program Manager

Location: St. Louis, Missouri (Remote)

Job Description:

Role Overview

We are seeking a Program Manager to lead complex Healthcare IT programs. This role focuses on prior authorization automation, improving integration between providers and payers, and reducing administrative burden across the revenue cycle. The position involves leading large, cross-functional programs and requires strong stakeholder and executive communication skills.

Key Responsibilities

• Deliver programs across scope, schedule, budget, and quality constraints.
• Lead cross-functional teams and manage multiple concurrent projects.
• Manage risks, issues, budgets, and overall program execution.
• Drive stakeholder alignment across clinical, IT, and payer teams.
• Lead vendor partnerships and drive the adoption of new workflows and systems.

Required Qualifications

Experience:

• 5-7+ years of Healthcare IT Program Management experience.
• Proven experience with Revenue Cycle processes.
• Knowledge of Prior Authorization workflows.
• Experience leading large, cross-functional programs.

Technical Skills:

• Prior Authorization and Utilization Management workflows.
• HL7 FHIR and interoperability frameworks (e.g., Da Vinci guides).
• EDI transactions (e.g., X12 278).
• EHR integrations (Epic, Cerner).

Education:

• A Bachelor's degree is required, with a preference for a technical field.

Preferred Qualifications

• PMP / PMI certification is preferred.

Regulatory Knowledge

• Familiarity with CMS prior authorization mandates.
• Understanding of HIPAA / PHI compliance.

We are an equal opportunity employer and welcome applications from all qualified candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico.

Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. 

Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Everforth Apex Systems.

Employee Type:

Contract

Remote:

Yes

Location:

St. Louis, MO, US

Job Type:

Scientific and Clinical

Pay Range:

$80 - $127 per hour