Podcast Summary
Podcast: Becker’s Healthcare Podcast
Episode: Leading Revenue Cycle Transformation at UNC Health with Stephen Rinaldi
Date: December 11, 2025
Host: Andrew Kass
Guest: Stephen Rinaldi, Senior Vice President and Chief Revenue Officer, UNC Health
Episode Overview
This episode features an in-depth discussion with Stephen Rinaldi, Senior Vice President and Chief Revenue Officer at UNC Health. The conversation centers on the transformation of the revenue cycle at UNC Health, the key challenges facing healthcare organizations today—including regulatory, labor, and reimbursement headwinds—and Stephen's approach to developing future leaders and leveraging technology for sustained financial and operational performance.
Key Discussion Points & Insights
Stephen Rinaldi's Background & Strategic Perspective
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[00:58-02:56]
- Rinaldi outlines his experience in finance and healthcare, noting his CFO background and how it shapes a more strategic, forward-thinking approach to revenue cycle leadership.
- Emphasizes using financial forecasting and strategy, rather than just backward-looking performance metrics, to anticipate and maneuver amid industry headwinds.
Notable Quote:
"The real lens that I bring is that forward-looking strategic financial plan around how we operate from a revenue perspective."
—Stephen Rinaldi [02:36]
Current Headwinds in Healthcare Revenue Cycle
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[03:02-04:41]
- Policy and reimbursement changes (Medicare, Medicaid)
- Ongoing labor challenges, especially increased competition for remote/hybrid roles post-pandemic
- Payer administrative burdens such as increased authorizations and audits
- Rapid technological change—both a challenge and an opportunity
Notable Quote:
"Labor challenges continue to be something that we face organizationally... the marketplace is national and even international since COVID, which has really changed the dynamic."
—Stephen Rinaldi [03:33]
Developing the Next Generation of Revenue Cycle Leaders
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[04:41-08:09]
- Hiring strategy focused on candidates who exhibit both success and lessons learned from failure.
- Importance of acting quickly to recruit top talent—sometimes even before specific roles are available.
- Prioritizing leaders who drive execution and can challenge teams to deliver more with focused, prioritized efforts.
- Building leadership “bench strength” through coaching, education, training, and shadowing.
Notable Quote:
"If we see someone and think, gosh, they're a star... I think you need to think about making [a role] because it’s important to secure that talent for the organization when it’s available."
—Stephen Rinaldi [05:34]- Red flags: Lack of professional following can indicate leadership weaknesses.
- Leaders must be prepared to make tough calls on team composition, including reallocations or facilitating outplacement if necessary.
Preparing for the ‘One Big Beautiful Bill Act’ (OB3)
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[08:09-11:36]
- OB3 and related legislative changes threaten reductions in supplemental programs vital to closing the gap between cost and Medicare/Medicaid reimbursement.
- Post-COVID inflation in labor and supply costs increases pressure on margins.
- Importance of robust revenue integrity: Ensuring clinical services convert to net revenue, minimizing patient liability surprises, and maintaining strong denial management programs.
- A pivot from solely measuring “cost to collect” to focusing on transactional productivity and leveraging technology.
Notable Quote:
"Most organizations cannot reduce cost quickly enough to offset a loss of revenue... so you really have to be excellent in converting clinical services into net revenue."
—Stephen Rinaldi [09:40]
Wins of 2025: Transitioning the Revenue Cycle Model
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[11:36-13:16]
- The transition from a Professional/Hospital-Based (PBHB) model to a “front-middle” revenue cycle model using the Epic platform.
- Success attributed to exceptional team recruitment and a culture rooted in teamwork, humility, and continuous learning—augmented by the academic environment at UNC Health.
Notable Quote:
"By far the strength of team in our transition of revenue cycle operations... has been our greatest win."
—Stephen Rinaldi [11:51]
Top Priorities for 2026
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[13:16-15:47]
- Continued alignment and support of clinical operations to achieve UNC Health’s mission.
- Emphasizing operating performance (“no margin, no mission”) as foundational to reinvestment in care delivery.
- Deliberately understanding and resourcing key service lines, especially in surgical and utilization management.
- Ongoing leadership development, especially in the age of AI and automation. Addressing employee anxieties about technology replacing roles by emphasizing upskilling and enabling staff to work at the top of their abilities while tech enhances efficiency.
Notable Quote:
"The buzzword I like to use is deliberate revenue integrity... focusing to the extent we can on being precise."
—Stephen Rinaldi [14:52]
Effective Revenue Cycle Leadership: Fundamental Traits
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[15:47-18:36]
- Success as a revenue leader is grounded in self-awareness, integrity, humility, and a drive to create internal discipline for execution.
- Leaders should be accountable, inspired by concepts like “extreme ownership” (Jocko Wilnick): There are no bad teams, only bad leaders.
- “Cover and move:” Foster teamwork across departments, break down silos, and promote cross-functional collaboration.
- Acknowledgement that effective leadership in revenue cycle involves partnering organization-wide and learning continuously from both successes and mistakes.
Notable Quote:
"There are no bad teams, there’s only bad leaders."
—Stephen Rinaldi (quoting Jocko Wilnick) [16:32]Notable Quote:
"Some leaders are born that way, but I think many people learn to lead and you do that by making mistakes and learning from them."
—Stephen Rinaldi [18:26]
Memorable Moments & Quotes
-
Strategic Financial View:
“...pivoting our operation, if you will, to where we need to be.” —Stephen Rinaldi [02:18] -
On Attracting Talent:
“Being able to hire talent when it's available, even when we don't have a role.” —Stephen Rinaldi [05:28] -
On Leadership Red Flags:
“If they're coming in and they're not telling you about teammates that they'd like to bring along... it's a red flag.” —Stephen Rinaldi [06:53] -
Revenue Integrity’s Importance:
“You have to be excellent in converting clinical services into net revenue.” —Stephen Rinaldi [09:44] -
On Team Culture:
“The people are the most important part of that operation. And that's why I really feel like it's the biggest win…” —Stephen Rinaldi [12:58] -
Adapting to AI:
“A lot of that is around setting a priority of continuing to elevate our team to operate at the top of their training, at the top of their license, if you will, and leveraging technology to make their life easier.” —Stephen Rinaldi [14:18]
Timestamps for Key Segments
- Stephen Rinaldi’s background & UNC Health overview: [00:58–02:56]
- Current industry headwinds: [03:02–04:41]
- Leadership development strategies: [04:53-08:09]
- OB3 & revenue cycle policy changes: [08:25-11:36]
- 2025 wins—revenue cycle transformation: [11:48-13:16]
- 2026 priorities & technological adaptation: [13:16–15:47]
- Traits of effective revenue cycle leadership: [15:55-18:36]
Closing
This episode offered actionable insights for healthcare executives and revenue cycle leaders, with a strong emphasis on strategic planning, team-building, and adaptability amid ongoing industry change. Rinaldi’s emphasis on deliberate leadership, technological agility, and people-first culture provides a compelling roadmap for successfully navigating future health system transformation.