The posting
Head of RCM Operations
Location: Kochi, India Work Hours: 3:00 PM – 12:00 AM IST Reporting to: CEO Experience: 8+ years preferred
About Needletail Needletail is building an AI-powered Revenue Cycle Management (RCM) platform for U.S. healthcare providers.
We believe the future of RCM will be built by combining intelligent AI agents with strong operational processes and human expertise. Our goal is to transform traditionally manual, repetitive, and time-intensive RCM workflows into highly automated, scalable, and outcome-driven operations.
As we scale, operations will be at the heart of our ability to deliver exceptional results for our customers.
We are looking for a Head of RCM Operations to build and lead that operating engine.
The Role As Head of RCM Operations, you will own the day-to-day delivery and scaling of Needletail’s RCM operations.
You will initially lead a team of approximately 20 people, with the expectation that the organization will scale to 100+ team members as the business grows.
This is a highly hands-on leadership role. You will be responsible not just for managing a team, but for building the systems, processes, culture, metrics, and operating discipline required to scale a high-performing RCM organization.
You will work closely with the CEO, product, technology, and customer-facing teams to ensure that Needletail consistently delivers high-quality outcomes for U.S. dental practices.
The ideal candidate has spent significant time operating large teams in software, KPO, BPO, shared-services, or other high-volume operational environments and has personally experienced the challenges of rapidly scaling teams while maintaining quality and productivity.
What You Will Own 1. RCM Delivery & Operations
- Own end-to-end operational delivery of RCM services for Needletail’s customers.
- Establish clear operating processes, workflows, SLAs, and accountability across the RCM organization.
- Ensure consistent delivery of high-quality outcomes across customer accounts.
- Identify operational bottlenecks and continuously improve throughput, quality, and efficiency.
- Build an operating model that can scale from tens of employees to hundreds without proportional increases in complexity.
2. Building Repeatable Processes
- Design and implement standardized, repeatable RCM processes.
- Document SOPs, workflows, escalation mechanisms, and operating guidelines.
- Identify processes that should be automated and work closely with the product and engineering teams to enable that automation.
- Continuously evaluate where humans, AI agents, and human-in-the-loop workflows should be deployed.
- Build a culture of operational excellence and continuous improvement.
3. Team Building & Hiring
- Own the hiring and onboarding strategy for the RCM organization.
- Build a high-performing team across different levels of the organization.
- Define organizational structure, roles, responsibilities, and career paths.
- Develop strong frontline and middle-management leadership as the organization scales.
- Establish hiring standards that allow Needletail to rapidly grow without compromising talent quality.
4. Workforce Planning
- Forecast operational capacity requirements based on customer growth and workload.
- Build staffing models and determine the right team size and structure for different operational requirements.
- Optimize utilization, productivity, shift coverage, and allocation of resources.
- Develop mechanisms to anticipate capacity constraints before they impact customer delivery.
5. Productivity & Performance Management
- Establish clear operational KPIs and performance benchmarks.
- Track metrics such as productivity, quality, turnaround time, SLA adherence, utilization, and error rates.
- Create performance management systems that identify both high performers and operational gaps.
- Develop mechanisms to continuously improve individual and team productivity.
- Use data to drive operational decisions rather than intuition alone.
6. Quality Assurance
- Build and own the RCM quality framework.
- Establish QA processes, sampling methodologies, quality benchmarks, and feedback loops.
- Ensure that AI-assisted and human-executed work consistently meets customer and industry standards.
- Identify recurring quality issues and work with product, training, and operations teams to address their root causes.
- Build processes that maintain quality as the organization scales rapidly.
7. Customer & Client Operations
- Work directly with U.S. dental practices and customers to understand operational requirements and challenges.
- Own operational relationships with customers and ensure delivery expectations are consistently met.
- Establish strong escalation and issue-resolution mechanisms.
- Translate customer feedback into operational improvements and product requirements.
- Help build trust with customers by demonstrating strong operational discipline and accountability.
8. Scaling Operations A major part of this role will be navigating the challenges that come with rapid organizational growth.
You will be expected to:
- Build systems that work at 20 people and continue to work at 100+.
- Develop managers and leaders rather than becoming the bottleneck for every decision.
- Introduce the right processes and controls at the right stage of growth.
- Balance speed with quality.
- Anticipate operational problems before they become customer problems.
- Build an organization that can absorb significant increases in customer volume without operational breakdowns.
What We’re Looking For
Required
- 8+ years of professional experience, preferably with significant experience managing large operational teams.
- Experience leading teams in KPO, BPO, software operations, shared services, healthcare operations, or another high-volume operational environment.
- Demonstrated experience scaling teams rapidly.
- Strong understanding of process design, standardization, SOPs, and operational excellence.
- Experience managing managers and large frontline teams.
- Strong understanding of workforce planning, productivity management, QA, and performance management.
- Strong analytical and problem-solving skills.
- Excellent communication and stakeholder-management skills.
- Comfort working directly with U.S.-based customers and operating in a U.S.-aligned work schedule.
- Willingness to work 3:00 PM – 12:00 AM IST.
- Based in or willing to work from Kochi.
Preferred
- Experience in U.S. healthcare operations.
- Experience in dental RCM or healthcare RCM.
- Experience working with U.S. dental practices, healthcare providers, payers, or healthcare technology companies.
- Experience operating in an AI-enabled or technology-driven services environment.
- Experience building human-in-the-loop operations around automation or AI.
- Experience taking an operation from an early-stage team to 100+ employees.
- Experience working in a high-growth startup environment.
What Great Looks Like The person who succeeds in this role will be someone who can look at a messy, manual operational process and ask:
“How do we turn this into a predictable, measurable, repeatable system?” You should be comfortable moving between strategy and execution — from designing the organizational structure to sitting with a team lead and figuring out why productivity dropped 8%.
You should know how to build processes without creating unnecessary bureaucracy, and how to introduce operational discipline without slowing down a fast-moving company. Most importantly, you should understand that scaling an operation isn’t simply about hiring more people. It requires better processes, stronger managers, better training, tighter quality systems, smarter workforce planning, better technology, and continuously improving productivity.
Key Success Metrics Your success will ultimately be measured by the ability to build a high-performing and scalable RCM organization.
Key metrics will include:
- Customer SLA adherence
- RCM operational quality
- Team productivity
- Operational efficiency
- Employee utilization
- Hiring and ramp-up velocity
- Training effectiveness
- QA performance
- Employee retention
- Customer satisfaction
- Successful scaling of the organization from 20 to 100+ people
- Increasing the percentage of RCM workflows successfully handled through AI and automation
Why Join Needletail? This is an opportunity to build something fundamentally different from a traditional RCM operation. At Needletail, operations and AI are being built together.
You will have the opportunity to shape how an AI-powered RCM company actually operates deciding what should be automated, what should remain human-driven, how humans and AI agents should work together, and how the organization can deliver better outcomes as it scales.
You will work directly with the CEO and have significant ownership over one of the most critical functions of the company.
If you are someone who loves building teams, designing systems, solving operational problems, and scaling organizations, this is a chance to build the operating backbone of a company that is transforming healthcare RCM.
Who This Role Is For This role could be a strong fit for someone currently working as:
- Head / Director of Operations
- Operations Director
- Senior Operations Manager
- Delivery Head
- Process Head
- Business Unit Head
- Operations Leader
- KPO / BPO Operations Leader
- Healthcare Operations Leader
The strongest candidates will have a track record of taking ownership of large teams and complex operations and making them more predictable, measurable, efficient, and scalable.
