Vice President, Revenue Cycle Management

ModivCare Solutions; United States; Remote; USD 202,000 - 250,000; Full time

Job summary

ModivCare Solutions is seeking a strategic leader to head the Personal Care billing and claims department, shaping policy, improving efficiency, and ensuring HIPAA and regulatory compliance. You will drive process improvements, manage budgets, report to executives, and build a high-performing team across internal and external partners.

Bachelor's degree and 15+ years of leadership in billing/claims are required; salary range $202,300–$250,000 with bonus eligibility.

Qualifications

• Bachelor's Degree required, Master's Degree preferred.
• Fifteen (15) plus years progressive experience in billing and claims management.
• Ten (10) plus years leadership responsibility leading teams.
• Strong knowledge of industry regulations, compliance, and best practices.
• Exceptional leadership and people management skills.
• Excellent analytical, problem-solving, and decision-making abilities.
• Outstanding communication, negotiation, and interpersonal skills.
• Proven ability to build and maintain productive relationships with internal and external stakeholders.
• Proficiency in using billing and claims management software and systems.
• Highly organized and results-oriented with a keen eye for detail.

Responsibilities

• Develops and implements the strategic direction for the billing and claims department in alignment with the company's goals and objectives.
• Assesses and optimizes billing and claims processes to enhance efficiency, accuracy, and compliance, and ensure timely claim submissions
• Ensures all billing and claims activities adhere to industry regulations and company policies, including HIPAA, and maintain up-to-date knowledge of relevant regulations.
• Implements quality assurance measures to reduce errors, denials, and rejections, and oversee the resolution of complex billing and claims issues.
• Prepares and presents comprehensive financial reports and analysis to the CFO, Business Unit Leader, and stakeholders on a regular basis.
• Manages relationships with third-party billing and claims service providers and ensure optimal performance.
• Develops and manages the department's budget, optimizing resources while maintaining the highest level of service.
• Collaborates with internal stakeholders, such as the legal and compliance teams, and external partners to facilitate the resolution of complex claims issues.
• Stays abreast of emerging technologies and trends in billing and claims management, and lead the integration of innovative tools and systems.
• May lead projects and perform other duties as assigned.
• Determines appropriate resourcing of staff in order to achieve goals and objectives.
• Builds an effective senior leadership team through mentoring and formal education that focuses on management and project management principles.
• Defines annual Key Performance Indicators aligned with corporate goals.
• Directs and mentors senior leaders on performance gaps, career development opportunities, and strategies.
• Directs and coaches senior leaders on all human resource related processes including onboarding, performance management, succession planning, employee relations, selection, terminations, compensation and rewards.
• Accountable for strategic design, execution, and collective results along with others' successful contributions.
• Owns attainment of high employee satisfaction and retention; lead development of program and initiatives within group to attain high employee satisfaction.
• Directs and influences change management initiatives to drive improvements and efficiencies cross-functionally.
• Ability to direct and interact collaboratively and communicate effectively with external, internal customers, and stakeholders to address issues and ensure alignment across the organization to drive customer success.
• Prepares and manages budget as assigned; analyzes variances and initiates corrective actions to maximize operational performance.
• Occasional business travel may be required.

Skills

Leadership

Billing & claims

Regulatory compliance

Data analysis

Communication

Project management

Change management

Stakeholder management

Education

Bachelor's degree

Master's degree

Tools

Billing software

Job description

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!

This position is responsible for the Personal Care department's strategic initiatives and direction for all aspects of billing and claims operations. This role drives the optimization of the department processes, ensuring accuracy, efficiency, and adherence to industry regulations.

This role.. .

• Develops and implements the strategic direction for the billing and claims department in alignment with the company's goals and objectives.
• Assesses and optimizes billing and claims processes to enhance efficiency, accuracy, and compliance, and ensure timely claim submissions
• Ensures all billing and claims activities adhere to industry regulations and company policies, including but not limited to HIPAA, and maintain up-to-date knowledge of relevant regulations.
• Implements quality assurance measures to reduce errors, denials, and rejections, and oversee the resolution of complex billing and claims issues.
• Prepares and presents comprehensive financial reports and analysis to the CFO, Business Unit Leader, and stakeholders on a regular basis.
• Manages relationships with third-party billing and claims service providers and ensure optimal performance.
• Develops and manages the department's budget, optimizing resources while maintaining the highest level of service.
• Collaborates with internal stakeholders, such as the legal and compliance teams, and external partners to facilitate the resolution of complex claims issues.
• Stays abreast of emerging technologies and trends in billing and claims management, and lead the integration of innovative tools and systems.
• May lead projects and perform other duties as assigned.
• Determines appropriate resourcing of staff in order to achieve goals and objectives.
• Builds an effective senior leadership team through mentoring and formal education that focuses on management and project management principles.
• Defines annual Key Performance Indicators aligned with corporate goals.
• Directs and mentors senior leaders on performance gaps, career development opportunities, and strategies.
• Directs and coaches senior leaders on all human resource related processes including onboarding, performance management, succession planning, employee relations, selection, terminations, compensation and rewards.
• Accountable for strategic design, execution, and collective results along with others' successful contributions.
• Owns attainment of high employee satisfaction and retention; lead development of program and initiatives within group to attain high employee satisfaction.
• Directs and influences change management initiatives to drive improvements and efficiencies cross-functionally.
• Ability to direct and interact collaboratively and communicate effectively with external, internal customers, and stakeholders to address issues and ensure alignment across the organization to drive customer success.
• Prepares and manages budget as assigned; analyzes variances and initiates corrective actions to maximize operational performance.
• Occasional business travel may be required.

We are interested in speaking to individuals with the following.. .

• Bachelor's Degree required, Master's Degree preferred.
• Fifteen (15) plus years progressive experience in billing and claims management.
• Ten (10) plus years leadership responsibility leading teams.
• Strong knowledge of industry regulations, compliance, and best practices.
• Exceptional leadership and people management skills.
• Excellent analytical, problem-solving, and decision-making abilities.
• Outstanding communication, negotiation, and interpersonal skills.
• Proven ability to build and maintain productive relationships with internal and external stakeholders.
• Proficiency in using billing and claims management software and systems.
• Highly organized and results-oriented with a keen eye for detail.

Salary: $202,300 - $250,000

This role is bonus eligible based on individual and company performance.

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of the position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job.

Primarily seated work; extensive computer and telephone use; occasional standing, walking, reaching, bending, and lifting up to 10 lbs.

We value our team members and realize