Vice President

Creative Global Consulting; United States; On-site; USD 210,000 - 320,000; Full time

Job summary

Creative Global Consulting is seeking a Vice President of Payor Credentialing and Revenue Cycle Management to provide strategic leadership over all revenue cycle and credentialing processes. This executive will maximize reimbursements, ensure on-time credentialing, and drive financial performance through compliance and operational excellence.

Reporting to the CEO, you will lead a multi-disciplinary team, partner with IT to enhance data integrity of RCM platforms, and establish KPIs to monitor

Qualifications

• 10+ years leading healthcare revenue cycle and credentialing.
• Deep understanding of payor enrollment, reimbursement, and contracting.
• Experience leading large-scale process improvements and change initiatives.
• Strong communication, leadership, and strategic planning skills.
• Familiarity with CMS, NCQA, CAQH guidelines.

Responsibilities

• Develop and execute a comprehensive revenue cycle strategy aligned with organizational financial goals.
• Lead initiatives to improve payer contracting, collections, and reimbursement performance.
• Drive integration between credentialing, contracting, and revenue operations to reduce delays and denials.
• Oversee the provider credentialing process for all physicians, mid-levels, and facilities.
• Ensure timely and accurate payor enrollment and revalidation to prevent delays in billing and reimbursement.
• Maintain compliance with all payor requirements, accreditation standards, and regulatory mandates.
• Oversee the full revenue cycle including patient access, billing, coding, A/R, denial management, and collections.
• Establish KPIs and reporting structures to monitor performance and outcomes.
• Collaborate with IT to enhance the functionality and data integrity of RCM platforms.
• Ensure compliance with federal and state laws, payer policies, and healthcare regulations (HIPAA, CMS, OIG).
• Implement internal controls and audit processes to mitigate financial and compliance risks.
• Lead a large, multi-disciplinary team including directors, managers, credentialing specialists, billers, and coders.
• Foster a culture of accountability, excellence, and continuous improvement.
• Develop talent and succession planning strategies within the department.

Skills

Healthcare revenue cycle leadership

Payor enrollment & payer contracting

Process improvement & change mgmt

Performance management & KPIs

Strategic planning & leadership

Education

Bachelor’s degree in Healthcare Administration or related field

Master’s degree preferred

Job description

POP: 12+ months

Location: Remote, may be required to report on-site for meetings in Colorado

SCOPE

The Vice President (VP) of Payor Credentialing and Revenue Cycle Management provides strategic leadership over all aspects of the revenue cycle and credentialing processes. This executive is responsible for ensuring provider credentialing is completed accurately and on time, maximizing reimbursement from third-party payors, and driving financial performance through revenue integrity, compliance, and operational excellence.

REQUIRED SKILLS

• Bachelor’s degree in Healthcare Administration, Business, or related field (Master’s degree preferred).
• 10+ years of progressive leadership experience in healthcare revenue cycle and credentialing.
• Deep understanding of payor enrollment, medical billing, coding, reimbursement, and payer contracting.
• Demonstrated experience leading large-scale process improvements and change initiatives.
• Expertise in revenue cycle KPIs and tools for performance management.
• Strong communication, leadership, and strategic planning skills.

PREFERRED SKILLS

• Certified Revenue Cycle Executive (CRCE) – HFMA
• CPCS or CPMSM – National Association Medical Staff Services (NAMSS)
• Familiarity with pay systems and government payor programs (Medicare, Medicaid, Managed Care)

TASKS

• Develop and execute a comprehensive revenue cycle strategy aligned with organizational financial goals.
• Lead initiatives to improve payer contracting, collections, and reimbursement performance.
• Drive integration between credentialing, contracting, and revenue operations to reduce delays and denials.
• Oversee the provider credentialing process for all physicians, mid-levels, and facilities.
• Ensure timely and accurate payor enrollment and revalidation to prevent delays in billing and reimbursement.
• Maintain compliance with all payor requirements, accreditation standards, and regulatory mandates (e.g., CMS, NCQA, CAQH).
• Oversee the full revenue cycle including patient access, billing, coding, A/R, charge capture, denial management, and collections.
• Establish KPIs and reporting structures to monitor performance and outcomes.
• Collaborate with IT to enhance the functionality and data integrity of RCM platforms.
• Ensure compliance with federal and state laws, payer policies, and healthcare regulations (e.g., HIPAA, CMS, OIG).
• Implement internal controls and audit processes to mitigate financial and compliance risks.
• Lead a large, multi-disciplinary team including directors, managers, credentialing specialists, billers, and coders.
• Foster a culture of accountability, excellence, and continuous improvement.
• Develop talent and succession planning strategies within the department.