The Revenue Cycle Fellowship Program at Children’s Hospital of Philadelphia (CHOP) was intentionally created to address a very real gap we were seeing across healthcare: a lack of early‑career leaders with end‑to‑end revenue cycle understanding. As revenue cycle operations increasingly becomes more complex, spanning access, clinical documentation, payer policy, technology, and patient experience, we needed talent that can think systemically, not just within one function.

The program was designed as a sustainable talent pipeline within Revenue Cycle Operations (RCO), one that develops leaders who understand how decisions at one point in the cycle impact financial performance, compliance, and patient experience downstream. From the start, the goal

was not just education, but readiness: preparing fellows to step into high‑impact roles upon completion of the program.

The candidate journey is intentionally transparent and structured. Prospective fellows typically find the program through national administrative fellowship networks, CHOP recruitment channels, and informational webinars hosted by our current fellows and senior leaders.

Applicants submit materials through a centralized platform (recently NAFCAS), which allows us to standardize review and ensure equity in the selection process. From there, candidates move through a multi‑stage interview process that includes fellow‑led interviews, senior leader engagement, and an in‑person interview day. We’re very intentional about making the process two‑way, giving candidates a clear view into our culture, expectations, and the scope of the work.

We look for intellectual curiosity, humility, and systems thinking above all else. Strong candidates may not have deep revenue cycle experience yet, but they demonstrate the ability to connect dots, ask thoughtful questions, and translate data into insight.

Equally important is how candidates show up: how they communicate, collaborate, and respond to ambiguity. Revenue cycle leadership requires comfort operating across clinical, operational, technical, and financial domains, and the fellows who excel are those who embrace complexity rather than shy away from it. Leadership potential shows up early in how candidates listen, synthesize, and engage.

The fellowship is a two‑year program designed to build progressively. Year one focuses on foundational exposure, rotational experiences across the front, middle, and back end of the revenue cycle, combined with structured learning and short‑term projects. Fellows gain firsthand insight into functions like financial clearance, coding, revenue integrity, billing, and collections.

In year two, the program pivots from observation to project ownership. Fellows lead longer‑term initiatives, often tied directly to enterprise priorities, transformation efforts, or executive‑level assignments. Throughout both years, fellows regularly engage with senior leadership, governance forums, and cross‑functional teams to ensure they’re building both operational fluency, leadership skills and strategic judgment.

Several fellows have delivered meaningful, measurable impact, particularly in areas like digital enablement, revenue integrity, and executive reporting. One strong example is fellow‑led work supporting revenue cycle digital roadmaps and intake standardization, bringing structure to how initiatives are scoped, prioritized, and governed.

These efforts improved visibility for senior leaders, reduced rework, and accelerated decision‑making across RCO. In other cases, fellows have led coding centralization efforts, denial reduction initiatives, and executive‑ready analyses that directly informed leadership action. Importantly, these weren’t academic exercises, they were embedded in live operations with real financial and operational outcomes.

Fellows have also been in involved in Cyber Response Readiness Task Force efforts. And, they own the entire Revenue Cycle Operations Administrative Fellowship Recruitment process, and serve as mentors to the next cohort, when they learn valuable lessons in the recruitment, onboarding, and development.

The most important ingredient is intentionality. A fellowship program needs clear sponsorship, defined outcomes, and real work, not shadow roles or side projects. Fellows should be integrated into mission‑critical initiatives where their contributions matter.

It’s also essential to invest in mentorship, feedback, and governance so the program remains sustainable as cohorts grow. Finally, organizations should plan for what comes next, how fellows transition into permanent roles that benefit both the individual and the institution. When done well, a fellowship program isn’t just workforce development; it’s a strategic advantage.