AVP, RCM Operations Greater Raleigh, NC Area

The AVP, RCM Operations leads a portfolio of Revenue Cycle Services (RCS) clients and is accountable for its financial performance, client outcomes and growth. Leading a team of Client Executives and working closely with US and India delivery teams, the AVP owns portfolio profitability, KPI and SLA attainment, client retention and expansion, and the executive relationship with each client. The role turns revenue cycle data into action that keeps independent ambulatory practices financially healthy and independent.

Job Responsibilities:

Portfolio performance and financial results

• Own the financial performance of an assigned client portfolio (book of business), including revenue, gross margin and cost to serve
• Hold the portfolio to contracted KPIs and SLAs (such as days in A/R, A/R over 90 days, denial rate, clean claim rate and net collection rate) and lead corrective action when performance slips
• Forecast labor requirements and partner with US and India delivery leadership on staffing, productivity and quality
• Report portfolio performance, risks and forecasts to RCS leadership each month

Client relationships and retention

• Own the executive relationship with each client in the portfolio and act as executive sponsor for key accounts
• Monitor client health and renewal risk, and build and carry out retention plans for at-risk clients
• Lead resolution of client escalations, contract issues and payment disputes, working with Legal and Finance as needed
• Lead or take part in joint operating committees and business reviews with client leadership

Growth

• Identify and develop expansion opportunities within the portfolio, including onsite discovery at strategic accounts
• Support Sales on new business through discovery, solution scoping, pricing input and client references
• Oversee initial client builds and the integration of RCS services for new and expanding clients

Team leadership

• Lead, coach and develop a team of Client Executives: set goals, review performance and build bench strength
• Keep roles and accountabilities clear across Client Executives, Account Managers and delivery teams

Operational excellence and innovation

• Identify recurring issues across the portfolio and drive root-cause fixes and standard processes
• Serve as a resource on payer, regulatory and coding changes (such as payer outages and new coverage rules) and their impact on clients
• Evaluate and adopt technology, automation and AI that improve client outcomes and reduce cost to collect
• Ensure HIPAA, compliance and security requirements are met across the portfolio

Cross-functional collaboration

• Work across Operations, Product, Technology, Sales, Finance, Customer Success and Support to deliver a consistent client experience

Knowledge and Skills:

Technical: Deep knowledge of the full ambulatory revenue cycle (front end, mid cycle and back end), payer rules and RCM KPIs. Advanced proficiency with Excel and PowerPoint and with practice management, EHR and RCM reporting tools; experience with BI tools (such as Power BI or Tableau) preferred. Comfortable using AI and automation tools to analyze data and improve work.

Leadership: Builds accountable, high-performing teams; sets clear goals and coaches to them; makes decisions with incomplete information; prioritizes well under pressure, especially at month, quarter and year end. Represents RCS professionally with clients and internal partners.

Communication: Strong presentation and influencing skills; able to convey a compelling story about RCS to outsiders. Ability to speak clearly and to make effective and persuasive arguments and presentations to senior management and internal/external stakeholders. Strong written, oral, and interpersonal communication skills; Ability to present ideas in business-friendly and user-friendly language; Ability to read, analyze and interpret complex documents, including technical journals and service agreements. Ability to respond effectively to sensitive inquiries or complaints. Ability to write reports, business correspondence, financial reports and budgets.

Financial and analytical: Builds and interprets portfolio P&Ls, KPI dashboards and A/R analyses; uses data to find root causes and decide on action; reads and applies client service agreements and contract terms.

Qualifications & Experience

Bachelor's degree in Business, Healthcare Administration, or a related field; equivalent experience will also be considered.

10+ years of experience in Revenue Cycle Management (RCM), including outsourced and/or multi-client RCM operations.

5+ years of ambulatory practice operations or physician revenue cycle experience.

5+ years of financial management experience with direct P&L or portfolio accountability.

7+ years of leadership experience managing client-facing teams and/or people leaders, with responsibility for achieving organizational goals and performance metrics.

Preferred Qualifications

HFMA (CRCR or CHFP) and/or AAPC certification.

Experience working with offshore or global delivery teams (5+ years preferred)

Working Arrangements

Standard work week or as defined by assignment and client site requirements

Works hybrid model when not traveling, with substantial time on site at prospect and client locations

Requires after hours and weekend work during activations, go-lives, and escalations

Travel up to 25%

Compensation for this job is subject to market conditions, geographic considerations, the candidate’s unique skills and experience, state and local laws, and budget. Our commitment to pay transparency is a testament to our dedication to creating a fair, equitable, and inclusive workplace. By continuously analyzing market trends, staying abreast of changes in state laws, and making budgetary adjustments accordingly, we strive to ensure that our compensation practices reflect the value we place on our associates’ unique contributions and support their professional growth.

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Take a look at our Culture, Benefits, Early Talent Program, and Additional Openings.

Visa Sponsorship is not offered for this position.

At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

Veradigm’s policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

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