VP, Revenue Integrity & Recovery Strategy

Remote; San Francisco (CA); Remote; USD 180,000 - 240,000; Full time

Job summary

EnableComp is seeking a seasoned Revenue Integrity leader to guide the Revenue Recovery function in healthcare payer environments. You will set departmental goals, monitor financial targets, and drive continuous improvement with senior leadership.

You will oversee KPI development, staff hiring and training, and cross-functional collaboration to ensure on-time delivery of revenue objectives. Strong DRG and coding knowledge is essential, along with regulatory compliance and HIPAA familiarity.

Qualifications

• Bachelor's degree in HIM, nursing, healthcare administration, or related field.
• Active CCS, RHIT, or RHIA preferred.
• 7-10 years leadership experience in healthcare reimbursement, 5+ years in clinical denials or inpatient claims.
• Experience working with client-facing roles.
• Strong inpatient coding and DRG reimbursement knowledge.
• Experience with payer guidelines and hospital revenue cycle.
• Ability to lead cross-functional teams and manage priorities.
• Willing to travel 0-10%.

Responsibilities

• Acts as a subject matter expert in EnableComp Revenue Integrity related products, including DRG & DRGV, and Medical Necessity Denials & ED Downgrades.
• Define and establish departmental goals, financial targets, and KPIs aligned with company objectives.
• Assist in setting strategic direction of Revenue Recovery with senior leadership.
• Oversee development of quality and productivity metrics for Revenue Recovery.
• Lead training and rollout of process changes and best practices.
• Ensure processes and inventory to hit revenue expectations monthly, quarterly, and yearly.
• Responsible for hiring, staff training, and performance reviews.
• Coordinate resources to address action plans for clients and projects.
• Collaborate cross-functionally to guide planning, resource allocation, and partnerships.
• Set daily priorities to maximize impact and staffing alignment.
• Measure and report KPIs with corrective actions for variances.
• Explain variances to management regarding DRG reviews, billing activity, and revenue metrics.
• Research processes for improvements and SOP enhancements.
• Engage in high-level client relationships and ensure satisfaction with updates and escalations.
• Develop training materials and monitor trends to support onboarding and quality improvement.
• Build a high-performing team through leadership, coaching, and accountability.
• Maintain knowledge of regulatory/compliance requirements (HIPAA, coding guidelines).
• Maintain DRG coding, clinical documentation, and reimbursement knowledge.
• Other duties as required

Skills

Leadership

Healthcare reimbursement

DRG knowledge

KPIs & metrics

Client-facing

Education

Bachelors in HIM

Masters preferred

CCS/RHIT/RHIA

Job description

EnableComp is seeking a seasoned Revenue Integrity leader to guide the Revenue Recovery function in healthcare payer environments. You will set departmental goals, monitor financial targets, and drive continuous improvement with senior leadership.

You will oversee KPI development, staff hiring and training, and cross-functional collaboration to ensure on-time delivery of revenue objectives. Strong DRG and coding knowledge is essential, along with regulatory compliance and HIPAA familiarity.