VP, Revenue Optimization & Reimbursement

Overview

Be inspired.  Be rewarded. Belong. At Emory Healthcare. 

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be.  We provide: 

• Comprehensive health benefits that start day 1 
• Student Loan Repayment Assistance & Reimbursement Programs 
• Family-focused benefits  
• Wellness incentives 
• Ongoing mentorship, development, and leadership programs  
• And more  

Work Location: Atlanta, GA

Description

• The Vice President of Revenue Optimization & Government Reimbursement provides executive leadership for enterprise revenue integrity, Charge Description Master (CDM) governance, government reimbursement, and revenue optimization strategy across Emory Healthcare
• Reporting to the Chief Revenue Cycle Officer, this role is responsible for the strategic direction, operational performance, and financial outcomes of both Hospital Billing (HB) and Professional Billing (PB) revenue optimization functions, as well as the Government Reimbursement team
• The Vice President oversees Revenue Integrity, CDM, and Government Reimbursement and partners closely with Charge Capture, Finance, Managed Care, Compliance, and clinical leadership to ensure accurate, compliant, and optimized revenue realization across all payers, with specific accountability for governmental reimbursement strategy and regulatory alignment
• This role serves as a key enterprise executive partner driving revenue sustainability, regulatory compliance, and margin improvement through innovation, analytics, and system optimization
• Executive Revenue Optimization Leadership
  • Provide enterprise executive leadership for revenue integrity, charge capture alignment, and revenue optimization strategy across HB and PB
  • Oversee:
    • Revenue Integrity
    • Charge Description Master (CDM)
  • Government Reimbursement
  • Establish enterprise governance structures to ensure alignment with health system financial and operational priorities
  • Identify, quantify, and remediate revenue leakage through analytics, operational redesign, and technology enablement
  • Drive performance improvement initiatives impacting net revenue, compliance, and denial prevention
• Government Reimbursement Oversight
  • Provide executive oversight of Government Reimbursement strategy, including Medicare, Medicaid, and other federal/state reimbursement programs
  • Ensure organizational readiness and compliance with evolving CMS and state regulatory requirements
  • Oversee:
    • Cost report strategy and optimization 
    • Disproportionate Share Hospital (DSH) programs
    • Graduate Medical Education (GME) reimbursement 
    • Supplemental payment programs
    • Regulatory filing and audit coordination
  • Partner with Finance and Policy leaders to model reimbursement impacts and optimize governmental revenue streams
  • Serve as executive liaison for governmental reimbursement audits, appeals, and regulatory reviews
• Charge Description Master (CDM) Governance
  • Oversee enterprise CDM strategy, maintenance, and governance
  • Ensure compliant and optimized charging aligned with regulatory, payer, and contractual requirements
  • Lead enterprise CDM audits, charge reviews, and remediation initiatives
  • Drive standardization of charging practices across the system
• Documentation & Charge Capture Optimization
  • Partner with clinical, operational, and revenue cycle leaders to improve documentation impacting charge capture and reimbursement
  • Support provider and departmental education related to charging accuracy and compliance
  • Align charge capture workflows with digital and AI-enabled solutions
• Data, Analytics & Enterprise Strategy
  • Leverage advanced analytics to identify performance gaps, reimbursement risk, and optimization opportunities
  • Establish executive KPIs and dashboards for revenue optimization and government reimbursement performance
  • Partner with Digital and IT teams to deploy automation, AI, and system enhancements supporting middle revenue cycle transformation
• Collaboration & Executive Leadership
  • Serve as an enterprise executive partner across Revenue Cycle, Finance, Digital, Compliance, Legal, Managed Care, and Clinical Operations
  • Lead cross-functional