Vice President, Transformation Services – Denials Prevention

🕒 Setembro 11

🏖️ New Jersey – Remoto

🏖️ New Jersey – Remote

⏰ Tempo Integral

🔴 Especialista

👔 Vice-presidente

👻 Score fantasma 15%

O que significa: quão provável esta vaga está aberta sem contratação ativa.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

Candidatar-se

Encontrar Vagas Remotas Similares

Configurar Alerta de Email para Novas Vagas

📊 Verifique sua pontuação de currículo para esta vaga

Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

Enviar Currículo

Med-Metrix

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2010

🏥 Saúde

☁️ SaaS

💰 Private equity em 2025-09

Healthcare • SaaS

A Med-Metrix é uma empresa para a qual foi fornecida apenas uma presença mínima na web (a página apenas exibia "Carregando aplicativo... Seu navegador precisa ter o JavaScript habilitado... "). Nenhum produto, mercado ou detalhes de missão foram incluídos no texto fornecido. Com base apenas no nome da empresa, é plausível que foque em métricas médicas ou clínicas, análises ou software para a área de saúde, mas isso é especulativo e não confirmado pelas informações fornecidas. Mais detalhes públicos seriam necessários para ser mais específico.

Descrição

• Lead enterprise-wide denial prevention strategy and transformation across hospital revenue cycle operations • Identify and quantify opportunities to improve revenue yield by preventing avoidable revenue leakage before claims are submitted • Analyze denial, write-off, payer, and reimbursement data to identify root causes, emerging trends, and transformation opportunities • Establish a denial prevention framework focused on upstream prevention and first-pass payment • Develop prioritized transformation strategies based on financial impact, preventability, payer trends, operational performance, and implementation feasibility • Drive performance toward industry benchmarks for denial rates, preventable denials, clean claims, write-offs, overturn rates, and first-pass payment • Lead root-cause initiatives across Patient Access, Prior Authorization, Utilization Management, CDI, Coding, Revenue Integrity, Billing, Clinical Operations, and Payer Management • Develop payer-specific prevention strategies addressing authorization, medical necessity, clinical validation, DRG downgrades, level of care, coding, timely filing, eligibility, and payment policy issues • Identify payer behavior and policy changes and develop mitigation strategies • Partner with Managed Care and payer relations teams on systemic payer issues, contractual opportunities, and payer escalation • Define and monitor leading and lagging KPIs for denial outcomes and upstream prevention effectiveness • Evaluate workflows and technology to move edits and interventions earlier in the revenue cycle • Quantify transformation outcomes including net new revenue, avoided leakage, cash acceleration, reduced write-offs, and cost-to-collect improvement • Partner with operational leaders to ensure strategies are implemented, adopted, measured, and sustained • Develop standardized denial prevention methodologies, playbooks, benchmarks, and best practices across clients • Support client assessments, business development, and executive presentations by articulating opportunities and financial value • Foster continuous improvement, accountability, data-driven decision-making, and proactive revenue protection

🎯 Requisitos

• 10 years of progressive leadership experience in Revenue Cycle Management and Denials work • Bachelor's degree in Business Administration, Healthcare Administration, Finance, or a related field preferred • Proven experience in a leadership role within revenue cycle services, preferably in a healthcare hospital-based healthcare setting • Strong understanding of revenue cycle management principles and practices, with a demonstrated ability to deliver high-quality services to clients • Knowledge of state and federal governmental, legal, and regulatory provisions related to front-end, middle and backend revenue cycle operations • Excellent leadership skills, including the ability to motivate, mentor, and develop a high-performing team • Proficiency in revenue cycle management systems, electronic health records (EHR), and client management tools • Ability to adapt to a fast-paced and changing environment, managing multiple priorities and deadlines effectively • Proficiency in Microsoft Office Suite • Strong interpersonal skills, ability to communicate well at all levels of the organization • Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses • High level of integrity and dependability with a strong sense of urgency and results oriented • Excellent written and verbal communication skills required • Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes • Ability to move around the work area; light lifting required; sit; perform manual tasks; operate tools and office equipment; extend arms; kneel; talk and hear • Ability to follow directions, collaborate with others, and handle stress