Vice President, Operations

Vice President of Bill Review Operations

About the Company

Innovative healthcare solutions provider specializing in insurance services

Industry
Insurance

Type
Privately Held

Founded
2004

Employees
501-1000

Categories

• Insurance

Specialties

• bill review
• out-of-network repricing
• primary ppo and alternative repricing administration
• edi and clearinghouse solutions
• medical management
• data warehousing
• data analytics and plan modeling
• bill edits
• credentialing
• risk management
• health plan replacement
• medical networks
• care management & navigation
• utilization review
• disease management
• data transparency
• market-sensitive repricing
• payment integrity
• compliance management
• healthcare ecosystem
• and stop loss

About the Role

The Company is seeking a VP, Bill Review Operations to lead its Bill Review Services organization. The successful candidate will be responsible for setting and executing operational priorities, ensuring the achievement of business objectives, and overseeing the operational and financial performance of the organization. This role requires a leader with a strong background in healthcare operations, payment integrity, revenue cycle, bill review, managed care, or a related operational environment, with a proven track record of leading complex operations and driving strong performance. The VP will be expected to balance client needs, financial performance, and growth priorities, while fostering a culture of accountability, collaboration, and operational excellence. Key responsibilities for the VP, Bill Review Operations include leading the organization with a focus on operational performance, service delivery, and financial results, as well as partnering with the EVP, Payment Integrity to establish strategic direction and long-term growth plans. The role also involves building and developing a high-performing leadership team, championing operational excellence, and serving as the executive operational leader in various organizational and client-facing settings. The ideal candidate will have at least 10 years of progressive leadership experience, with a minimum of 5 years in a senior leadership role, and a Bachelor's degree in a relevant field. A Master's degree and experience in related healthcare services are a plus. The VP will be expected to have strong business and financial acumen, excellent communication skills, and the ability to influence and collaborate with senior stakeholders.

Hiring Manager Title
EVP, Payment Integrity

Functions

• Operations
• Medical Care/Hospital Administration