Vice President Payer Relations & Clearinghouse Operations

Vice President Payer Relations & Clearinghouse Operations

About the Company

Innovative healthcare technology company

Industry
Computer Software

Type
Privately Held, Private Equity-backed

Founded
2000

Employees
1001-5000

Categories

• Health Care
• Innovation Management
• Information Technology & Services

Specialties

• revenue cycle management
• healthcare information technology
• and claims management
• claims management
• healthcare payments
• patient payments
• patient financial experience
• financial clearance
• revenue capture
• denial management
• automation
• ai
• rpa
• robotic process automation
• hospitals and health systems
• physician groups
• healthcare claims management
• rcm
• healthit
• fintech
• and software

About the Role

The Company is seeking a Vice President of Payer Relations and Clearinghouse Operations to lead the development and management of innovative and transformative payer strategies, relationships, and agreements. The successful candidate will be responsible for operational management of the clearinghouse, ensuring compliance with industry standards and regulatory requirements, and overseeing the entire EDI and API data exchange related to the revenue cycle. This role requires the VP to maintain strong relationships with payers, negotiate contracts, and resolve disputes effectively. Additionally, the VP will be involved in technology and systems management, financial management, and will play a key role in the organization's strategic planning to ensure sustainable financial performance. Applicants for the VP position should have a minimum of 10 years of industry experience, with at least 5 years of experience in partnering with payers to deliver innovative healthcare information technology solutions. The role demands a proven track record of executive leadership, strategic planning, and budget formulation skills. The ideal candidate will have a Master's degree in a related field, experience with EHRs and other healthcare technology platforms, and a strong understanding of coding and billing practices. The VP must be dedicated to excellence, innovation, and continuous quality improvement, with a commitment to professional development and a focus on positive employee relations. Strong communication, leadership, and team-building skills are essential, as is the ability to work with all levels of management and external stakeholders.

Hiring Manager Title
EVP, Digital information & Cyber Security officer

Travel Percent
Less than 10%

Functions

• Information Technology
• Finance