Why some of my best RCM leaders never worked in healthcare

We do our best at hiring, but the real test starts once the seat is filled.

Hiring and retaining a strong RCM team is one of the hardest parts of an RCM leader’s job right now. We spend our days thinking about it. After years of building highly-effective teams, mostly by learning what works the hard way, I wanted to share some things that have actually helped with other leaders trying to hire and retain the people who keep the revenue cycle running.

Some of my best hires never worked in healthcare

Early in my leadership career, I was a healthcare purist. My first job was in a cardiology practice, and for years after that I leaned toward hiring candidates who'd built their whole career in a doctor’s office or a hospital.

I've since changed my mind. Interestingly, a lot of my best employees got their start in retail, then pivoted into healthcare. Many entered through Access roles like scheduling, registration, and check-in/admitting. The best ones stuck around and often grew into impact-driving RCM leaders.

Why retail and service translate

It's not that healthcare experience doesn't matter. Every newcomer to RCM has to climb the same learning curve. Rules and regulations, payor behavior, denials, appeal timelines, none of it is intuitive on day one.

But people who came up through retail or service arrive with an extra layer of resilience and flexibility that other industries don't always build.

Patient Access, in particular, has the same foundation retail and service does. It's a customer-service job first. Calming a patient who's upset about a scheduling issue or an unexpected bill, or holding your ground with a rep giving you the runaround, flexes the same muscle as retail employees when a shopper is angry that their favorite item is out of stock, or that they had to wait in a long check-out line.

The resume only tells you so much

Hiring isn’t a perfect science. I've had candidates with impressive resumes and past roles at some of the most prestigious companies wow me in an interview, and then struggle once they were actually doing the job. One leadership hire who'd come up from retail had a hard time figuring out staffing coverage, which was the one thing I expected to be second nature given their background.

Start with what the team actually needs

So how do you prepare for hiring the right person for your team? Before evaluating candidates, I look at what the team actually needs – not just in the role, but in the mix of skills already on the team. A highly effective team has to be diverse yet cohesive. If I'm hiring a manager, does the team need another analytical mind, an operations person, or someone who motivates people and builds relationships? What the current team needs most comes first.

Then look at the candidate, their posture toward the work, their attitude toward healthcare. I screen for that in the resume and in the interview, listening for real investment in the work. I pay attention to whether someone talks about problems as dead ends or a challenge to work through.

For managers, I run through a chaotic day

For manager roles, I go a step further with a case study. Not one that tests whether they can work a claim. That's not what their job requires. I want to see how they manage the people who do the work. I have them walk me through a chaotic day:

• A backlog that's building
• Team members out unexpectedly
• A new hire who isn't ramping the way you'd hoped
• A tenured employee whose numbers have quietly been slipping for weeks
• Verification requests piling up faster than anyone can clear them

I want to hear how they'd triage, what they'd reach for first, who they'd pull in to help, and what they'd let slide for a week to protect what matters most. I want their litmus test for whether the work is actually getting done right, not just getting done, and what they'd do the moment quality started slipping.

Dreamers, realists, and the people who dig

I also balance dreamers against realists:

• Dreamers are quick to see what a new workflow or a new piece of automation could do for the team.
• Realists anticipate what's going to break before changes roll out.

Growing a team or changing how it works takes real doses of both.

I also look for candidates with curiosity. Some people run into a payor rule they don't fully understand and dig deep on why it exists and where its limits actually are. Others just ask someone else and move on. I test for curiosity directly, too. Say someone's still calling the payor for a status check when the portal gives the same answer twice as fast. Why do it that way? A real answer means they've actually thought about the tradeoff. A shrug means they are just going through the motions.

How I'm approaching hiring right now

Right now I'm hiring across two kinds of roles, and the same thinking runs through both:

• On the leadership side, I care less about years in healthcare than whether someone is driven to grow junior leaders, not just manage them. I care about whether they've actually lived through a coverage crisis rather than just written a plan for one. That's the difference between a leader who keeps the operation organized and one who's just reacting to whatever hits first.
• On the AR side, I look for specialists who've done real AR follow-up and denial work and have real ideas about how to tackle and prevent the work from piling up. I look for people who'll move across specialties, learn how a new workflow actually runs, build the SOPs, train the next person, and stay curious enough to form real opinions that turn into recommendations.

The same thinking applies to promotions, not just new hires. Whatever the seat, filling it with a warm body isn’t enough.

The seat is the real test

None of this makes hiring a sure thing. You get clear on what the team needs, you screen for posture and curiosity, you run the case study. You still learn the most once someone is actually in the seat. That's the honest part of the work, and it cuts both ways. If the seat is where you really find out, then the resume shouldn’t be a stopping point in the hiring process.

I keep the candidate pool wide and stay open to the person who doesn't look the part on paper. We do our best at hiring, but the real test starts once the seat is filled. Some of my best people started nowhere near healthcare. Yours may, too.

How is your RCM hiring and retention going? No matter your workforce challenge, Amperos’s AI co-sourcing solution can help solve it. Reach out today to chat with our team.