FLAGLER HEALTH IS BUILDING THE CLINICAL OPERATING SYSTEM FOR MODERN MUSCULOSKELETAL CARE. We partner with MSK provider groups and specialty clinics to help them grow, operate more efficiently, and deliver better longitudinal care across patient acquisition, clinical workflows, and ongoing patient engagement. Our platform sits at the intersection of care delivery and clinic operations, helping providers capture more value across the full patient lifecycle. We’ve recently raised our Series B and are entering our next phase of growth. This is a mission-critical leadership role focused on operational excellence, scalability, workforce performance, and financial outcomes. Success in this role means building a high-performing India operation that becomes a durable strategic advantage for the company across RCM execution, process optimization, quality, compliance, and service delivery. We are hiring a Chief Operating Officer, India – RCM to lead the strategic oversight and day-to-day management of Flagler Health’s India operations organization, including end-to-end revenue cycle execution, team scaling, operational controls, and cross-functional alignment with U.S. leadership. You will oversee all India-based RCM operations while helping architect the next generation of scalable operational infrastructure across billing, collections, coding, claims management, denials, payment posting, credentialing support, and operational analytics. KEY RESPONSIBILITIES: OPERATIONAL LEADERSHIP & SCALE * Lead and scale Flagler Health’s India-based RCM organization across all operational functions, including authorizations, claims processing, AR follow-up, denials management, payment posting, eligibility verification, coding support, and credentialing operations. * Build and operationalize scalable delivery infrastructure capable of supporting rapid customer growth and increasing claim volume while maintaining high quality and SLA performance. WORKFORCE MANAGEMENT * Recruit, develop, and lead a high-performing organization across managers, team leads, and frontline RCM staff; establish performance standards, coaching frameworks, training programs, and succession planning processes. * Drive employee engagement, retention, and operational rigor across a distributed and growing workforce. KPI-DRIVEN OPERATING CADENCE * Establish a data-driven operating rhythm across all RCM functions, including productivity tracking, QA metrics, denial trends, collections performance, turnaround times, and client-level reporting. * Develop dashboards and performance management systems that provide transparency into operational health and financial outcomes. PROCESS OPTIMIZATION & AUTOMATION * Continuously identify opportunities to improve operational efficiency, reduce manual work, optimize workflows, and increase collections performance. * Partner closely with Product, Engineering, and Automation teams to implement AI-enabled workflows, automation tools, and operational infrastructure improvements across the RCM lifecycle. CROSS-FUNCTIONAL COLLABORATION * Serve as the primary operational bridge between India-based operations and U.S.-based executive leadership, Customer Success, Product, Finance, and clinical operations teams. * Ensure alignment across teams on service delivery expectations, operational priorities, escalations, and strategic initiatives. FINANCIAL & CLIENT PERFORMANCE * Own operational performance tied to revenue realization, collections efficiency, denial reduction, and customer retention outcomes. * Partner with executive leadership to support client implementations, operational forecasting, margin improvement, and strategic account growth. COMPLIANCE & QUALITY OVERSIGHT * Ensure all operations comply with HIPAA, payer requirements, healthcare billing regulations, and internal quality standards. * Establish strong QA and audit processes to maintain operational consistency, documentation accuracy, and compliance readiness. VENDOR & TECHNOLOGY MANAGEMENT * Manage relationships with third-party vendors, technology partners, and offshore infrastructure providers as needed. * Evaluate and implement tools that improve scalability, visibility, and operational efficiency across the organization. EXECUTIVE REPORTING * Provide regular updates, strategic plans, and operational reporting to executive leadership and Board stakeholders. * Develop operating models and long-term scaling plans that position the India organization as a core strategic function of the business. Requirements: * 10+ years of experience in healthcare operations, revenue cycle management, BPO operations, or healthcare services leadership, with significant experience managing large-scale India-based teams. * Proven track record of scaling RCM or healthcare operations organizations in high-growth, fast-paced environments preferably in MsK. * Live in or near Ahmedabad, India. * Deep expertise across the end-to-end U.S. healthcare revenue cycle, including authorizations, claims management, denials, collections, coding workflows, payer operations, and operational performance metrics. * Experience managing organizations with 100+ employees across multiple operational functions and leadership layers. * Strong operational and analytical foundation, including KPI development, workforce planning, forecasting, capacity management, and process optimization. * Experience working cross-functionally with U.S.-based leadership teams and supporting global operational alignment. * Experience leveraging automation, AI tools, workflow systems, and operational technology to improve efficiency and scalability. * Bachelor’s degree required. Non-Functional Skills & Cultural Fit: * Thrives in fast-paced, ambiguous, high-growth environments. * Highly systems-oriented with strong operational discipline and attention to detail. * Low ego, highly collaborative, and willing to roll up sleeves to solve problems. * Resilient, adaptable, and deeply ownership-driven. * Balances strategic thinking with operational rigor and urgency. * Strong bias toward action and continuous improvement. OUR VALUES This is what you can expect of your teammates at Flagler: * Persistence + ownership of outcomes: We wear many hats and aren’t afraid to run through walls to solve hard problems. * Personal + professional growth: We push ourselves to learn new things and embrace challenges, even if it means that we sometimes fail. * Don’t take things personally: We value and react quickly to constructive feedback. * Speed is our ally: In the fast-paced world of startups, we understand the value of moving swiftly. We thrive on the adrenaline of working rapidly. * Be Right: We are highly detailed oriented and try to be right, a lot.