Vice President - Operations: End-to-End RCM US Healthcare Title
Vice President, RCM Operations
Work Location: Mumbai, India
Reports To: Head Operations
Role Overview
The Vice President of RCM Operations will lead large-scale service delivery and transformation initiatives in the US Healthcare RCM domain, managing 2000+ employees across multiple accounts. The role demands proven leadership in end-to-end RCM operations, deep client engagement, operational excellence, and a forward-looking vision to drive profitability, process automation, and best-in-class client Responsibilities:
People Leadership
- Provide strategic leadership to large operations, ensuring productivity, quality, compliance, and profitability.
- Mentor and develop senior leaders (directors, managers, senior managers, AMs, TLs, SMEs, and trainers) to create strong succession pipelines.
- Drive employee engagement, talent retention, and leadership development across all levels.
- Manage multiple accounts with diverse RCM workstreams (AR, Denials, Billing, Payment Posting, Coding, Patient Access).
- Implement robust attrition management and skill enhancement Management & Service Delivery:
- Ensure operational excellence across end-to-end RCM services, including:
- Medical Coding
- Billing, Charge Capture, and EDI Transactions
- Payment Posting
- AR Follow-up, Denials Management, Appeals
- Credit Balance & Refunds
- Monitor workflows to achieve SLA, TAT, and quality benchmarks.
- Partner with clients to co-create strategies for AR reduction, denial prevention, and cash acceleration.
- Conduct executive-level business reviews to ensure client confidence and long-term Management & Business Growth:
- Drive overall P&L, ensuring revenue realization, cost optimization, and margin expansion.
- Identify and convert growth opportunities across existing and new accounts.
- Lead pricing discussions, cost modelling, and contract negotiations with clients.
- Partner with Business Development and Solutions teams to support RFPs and client & Risk Management:
- Ensure adherence to HIPAA, CMS, OIG, and payer compliance standards.
- Implement robust internal controls to mitigate financial, compliance, and reputational risks.
- Regularly audit processes to ensure accuracy, regulatory alignment, and client & Transformation:
- Drive adoption of automation (RPA, BOTs), AI/ML tools, and advanced analytics to improve efficiency.
- Partner with technology teams to implement workflow tools, knowledge management platforms, and predictive dashboards.
- Champion digital transformation initiatives such as Denial Predictors, AR Worklist Automation, and Real-time Eligibility/Authorization APIs.
- Standardize best practices across accounts for scalable Excellence:
- Lead continuous improvement initiatives using Lean, Six Sigma, and data-driven insights.
- Conduct root cause analysis for denials, underpayments, and process breakdowns.
- Develop frameworks for Critical to Cash (CTC) metrics and ensure E2E accountability across functions.
- Build governance models (daily/weekly/monthly cadence) to ensure delivery & Experience:
- Graduate / Postgraduate with 18+ years of experience in US healthcare RCM with deep expertise in end-to-end RCM processes.
- The candidate should be at the Associate Vice President level or hold an equivalent role
- Proven track record of managing large-scale operations (1000+ FTEs) with direct P&L accountability.
- Strong client-facing leadership experience with US healthcare providers, payers, and MSOs.
- Demonstrated success in driving automation, analytics, and digital transformation in RCM.
- Strong business acumen with ability to balance operations, growth, and client relationships.
(ref:iimjobs.com)
