Key Responsibilities 

Strategic Leadership & Vision: 

• Develop and execute the overall vision and strategy for the Revenue Recovery service line, ensuring alignment with corporate goals. 

• Serve as the company's foremost subject matter expert on denial management and underpayment recovery, advising executive leadership on market trends, strategic opportunities, and emerging technologies. 

• Drive a culture of accountability, continuous improvement, and high performance within the team, fostering individual motivation and professional development. 

• Establish and own the service line's P&L, developing and managing operating budgets, forecasting revenue, and ensuring profitability. 

Operational Oversight & Performance Management: 

• Provide executive leadership and oversight for the Clinical Nurse Manager and the Revenue Recovery Manager, ensuring their teams meet and exceed all operational and financial targets. 

• Define, monitor, and report on Key Performance Indicators (KPIs), including denial rates, appeal success rates, recovery velocity, A/R days, and cost-to-collect. 

• Lead the continuous optimization of workflows within the Health Innovas "Pulse" platform and our selected AI partner's tools to maximize efficiency and effectiveness. 

• Analyze performance data to identify systemic root causes of revenue leakage and lead the development of enterprise-level prevention strategies. 

Client & Stakeholder Collaboration: 

• Serve as the primary executive liaison for the Revenue Recovery service, building and maintaining strong, collaborative partnerships with Insource client leadership, including hospital CFOs and VPs of Finance. 

• Prepare and deliver executive-level presentations and business reviews to clients, translating complex operational data into clear financial impact and strategic recommendations. 

• Collaborate effectively with internal leaders, including the Business Enablement team, IT, and Sales, to ensure seamless service delivery and strategic alignment. 

Technology & Innovation: 

• Lead the strategy for leveraging technology to create a competitive advantage, including the full optimization of the Pulse platform and the integration of agentive and generative AI tools. 

• Develop and maintain a roadmap for automation to improve processes, reduce administrative burden, and lower the overall cost-to-collect. 

Qualifications and Skills 

Required: 

• Bachelor’s Degree in Healthcare Administration, Business, Finance, or a related field. Master’s Degree (MHA, MBA) is highly preferred. 

• A minimum of 10 years of progressive experience in healthcare revenue cycle management, with deep expertise in back-end operations, including denial management, underpayment recovery, and AR management. 

• At least 5 years of experience in a senior leadership role (Director level or above) with a proven track record of building and leading high-performing teams and managing a P&L. 

• Strong financial acumen and exceptional analytical skills, with the ability to analyze complex data sets, identify trends, and make data-driven strategic decisions. 

• Excellent communication, presentation, and interpersonal skills, with the ability to build trusted relationships and communicate effectively with C-suite executives, clinical leaders, and internal teams. 

Preferred: 

• Experience in an outsourced RCM, vendor, or consulting environment. 

• Demonstrated experience implementing and optimizing revenue cycle technologies, including workflow management platforms and AI/automation tools. 

• Industry certifications such as HFMA-CRCR or FHFMA. 

• Experience with LEAN, Six Sigma, or other process improvement methodologies.