Director, DRGV & Revenue Optimization

Revecore

Kansas (OH)

Remote

USD 180,000 - 240,000

Full time

3 days ago

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Job summary

Revecore is seeking a Director, Diagnosis-Related Group Validation (DRGV) to lead the development and launch of our DRGV service offering, expanding Billing and Coding Optimization capabilities. You will translate industry knowledge into scalable processes, technology-enabled workflows, staffing and pricing models for go-to-market success.

The role blends deep DRGV expertise with strategy and execution, requiring collaboration with Product, Data, AI, and Operations to drive AI-driven

Qualifications

Hands‑on DRGV coding experience and strong DRGV outcomes knowledge.
Expert MS-DRG classification and reimbursement understanding.
Knowledge of CDI and revenue cycle concepts.
Experience interpreting payer contracts and claim adjudication processes.
Designed or led DRGV programs, workflows, and productivity metrics.
Experience partnering with Product/Engineering to build scalable solutions.

Responsibilities

Define operating model, workflows, staffing, and quality standards for scaling the service line.
Provide DRGV SME expertise across coding, MS-DRG, revenue integrity, and claims.
Collaborate with Product, Data, AI, Development, and Operations to translate DRGV requirements into scalable processes and technology solutions.
Identify opportunities to apply AI and automation to DRGV processes and delivery.
Serve as liaison between DRGV SMEs and Product/Engineering teams for software development needs.
Set performance expectations and monitor progress against goals and financial targets.