VP of Revenue Cycle Operations, Payer Accountability

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. 

As our Vice President of Revenue Cycle Operation – Payers Accountability, you will be responsible for overseeing and enhancing the payer escalation process within the revenue cycle management (RCM) operations. Every day, you will be expected to work closely with the senior leaders to optimize payer performance, resolve escalated issues efficiently, and drive revenue integrity across the organization. To thrive you must be a strategic leader with extensive experience in revenue cycle management, payer relations, and dispute resolution. 

Here’s What You Can Expect 

• Strategy Development & Leadership 
• Develop and implement strategies to improve payer escalation processes. 
• Lead and mentor a team of RCM professionals focused on payer escalation. 
• Collaborate with senior leadership to align payer escalation strategies with organizational goals. 
• Payer Relations & Escalations 
• Establish and sustain strong relationships with key payers.  
• Negotiate resolutions for escalated issues  
• Monitor and analyze payer performance, identifying trends  impacting revenue 
• Process Optimization & Compliance 
• Analyze and optimize existing payer escalation processes.  
• Implement best practices and innovative solutions to enhance efficiency and effectiveness.  
• Ensure compliance with industry regulations and standards throughout the escalation process. 
• Data-Driven Decision Making 
• Utilize data analytics to identify patterns and root causes of payer-related issues.  
• Prepare and present reports on payer performance and escalation outcomes to senior leadership.  
• Develop and monitor key performance indicators (KPIs) related to payer escalation. 
• Cross-Functional Collaboration & Training 
• Work closely with internal departments, such as billing, coding, and compliance to address payer-related issues.  
• Maintain clear and effective with payers, providers, and internal stakeholders. 
• Provide training and support to staff on best practices in payer escalation processes. 

Requirements 

• Minimum of 10 years of experience in revenue cycle management, with a focus on payer relations and escalation. 
• In-depth knowledge of healthcare regulations and payer policies. 
• Proven leadership experience, with the ability to manage and motivate a team. 
• Strong and broad understanding of Revenue Cycle Operations within a hospital setting. 
• Strategic vision and operational excellence across end-to-end solutions. 
• Exceptional negotiation and problem-solving skills. 
• Excellent communication and interpersonal abilities. 
• Proficiency in data analysis and reporting tools. 

For this US-based position, the base pay range is $170,956.00 - $274,007.40 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

This job is eligible to participate in our annual bonus plan at a target of 30.00%

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status