Vice President of RCM Operations

 Posted 2 months ago
     
10+ years experience
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AI Summary

This executive role involves defining and executing the enterprise operational strategy for revenue cycle services across Ambulatory and Hospital segments, driving the operational roadmap for revenue growth and service scalability. The Vice President will own operational performance supporting $45M in annual revenue, ensuring targets are met across core RCM metrics like DSO, AR aging, and denial rates.

Executive Leadership Responsibilities

Enterprise Revenue Cycle Strategy

  • Define and execute the enterprise operational strategy for revenue cycle services across Ambulatory and Hospital client segments.
  • Drive the operational roadmap that supports revenue growth, margin expansion, and service scalability.
  • Partner with executive leadership to align RCM operations with the company’s strategic growth and market expansion objectives.
  • Identify and implement initiatives that accelerate cash performance, operational efficiency, and client value delivery.

Financial Performance & EBITDA Accountability

  • Own operational performance supporting $45M in annual revenue, ensuring consistent achievement of financial and operational targets.
  • Drive improvement across core RCM performance metrics including:
    • Days Sales Outstanding (DSO)
    • AR aging and backlog management
    • Clean claim rate
    • Net collection rate
    • Denial rate and appeal success
    • Cash acceleration and revenue yield
  • Identify and eliminate revenue leakage across the revenue cycle.
  • Partner with Finance on budgeting, forecasting, margin improvement initiatives, and cost optimization.
  • Implement scalable operational models that improve productivity, quality, and profitability.

Global Operations Leadership

  • Provide executive leadership for a 700+ person global workforce operating across the U.S., India, and the Philippines, supported by multiple external contracting firms.
  • Oversee operational performance across all core revenue cycle functions including:
    • Coding
    • Patient services / call center operations
    • Credentialing and provider enrollment
    • Charge entry and billing/data entry
    • Payment posting
    • Claims follow-up
    • Denials management
    • Appeals
  • Establish governance and accountability structures across onshore, offshore, and vendor-delivered operations.
  • Lead workforce strategy including capacity planning, staffing models, vendor utilization, and global labor optimization.

Operational Transformation & Process Excellence

  • Drive enterprise-wide operational transformation initiatives to modernize and scale revenue cycle operations.
  • Implement standardized operating models including:
    • Enterprise SOPs
    • Quality assurance frameworks
    • Productivity benchmarks
    • Workflow standardization
    • Global performance management
  • Lead continuous improvement initiatives using Lean, Six Sigma, and data-driven operational methodologies.
  • Champion adoption of automation, AI-enabled RCM technologies, and robotic process automation (RPA) to improve efficiency and accuracy.

Technology & Multi-Platform Operational Enablement

  • Provide operational oversight across 30+ EHR, practice management, and billing platforms supporting a diverse healthcare client base.
  • Partner with Product, Technology, and Engineering teams to:
    • Improve system interoperability
    • Enable automation and workflow orchestration
    • Enhance analytics and reporting capabilities
    • Reduce manual operational dependencies
  • Support technology-enabled revenue cycle innovation that differentiates the organization in the market.

Client Delivery & Strategic Partnership

  • Serve as the senior operational leader responsible for client delivery excellence and SLA performance.
  • Partner with Client Success and Account Management teams to drive:
    • Client satisfaction and retention
    • Transparent performance reporting
    • Proactive issue resolution
    • Strategic operational improvements
  • Participate in executive-level client governance meetings, QBRs, and escalation management.
  • Support sales and growth initiatives, including participation in RFP responses, operational due diligence, and new client onboarding strategies.

Analytics, Reporting & Operational Intelligence

  • Establish enterprise performance dashboards and reporting frameworks that provide real-time visibility into revenue cycle performance.
  • Leverage analytics to drive improvement across:
    • Payer performance
    • Denial root causes
    • AR aging trends
    • Workforce productivity
    • Client financial outcomes
  • Deliver executive-level reporting and insights to C-suite leadership and board stakeholders.

Organizational Leadership & Talent Development

  • Build and lead a high-performing global leadership team including Directors, senior operational leaders, and functional experts.
  • Establish leadership development programs that strengthen organizational depth and succession planning.
  • Foster a culture centered on:
    • Accountability
    • Operational excellence
    • Continuous improvement
    • Client-centric service delivery
  • Drive workforce engagement within a large-scale remote and distributed workforce model.

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