Vice President of Operations: End-to-End RCM US Healthcare

9820540505.Job Title

Vice President, RCM Operations

Work Location:

Reports To:

• 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 frameworks.

Client 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 growth.

P&L 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 onboarding.

Compliance & 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 trust.

Technology & 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 operations.

Process 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 discipline.

Qualification & 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.

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