Senior Vice President of Eligibility, Claims & Revenue Management

Senior Vice President of Eligibility, Claims & Revenue Management

About the Company

Top fertility benefits management company

Industry

Hospital & Health Care

Type

Public Company

Founded

2008

Employees

501-1000

Categories

• Fertility
• Health Care
• Medical

Specialties

Business Classifications

About the Role

The Company is in search of a Senior Vice President of Eligibility, Claims, and Revenue Management to take on a pivotal executive role. The successful candidate will be tasked with leading and optimizing the company's core operational processes, with a direct impact on revenue recognition, customer satisfaction, and compliance. This strategic and operationally strong leader will be responsible for the end-to-end eligibility function, ensuring accurate onboarding and billing, and will provide strategic oversight of outsourced claims processing partners. The role also involves overseeing all carrier and member revenue operations, driving system enhancements, and process automation to support scalable operations, and defining and monitoring KPIs across all revenue cycle functions. Candidates for this role at the company should have a Bachelor's degree in a relevant field, with a Master's degree preferred, and at least 15 years of experience in revenue cycle management, including a minimum of 5 years in a senior leadership position. A strong background in healthcare operations, particularly in claims processing, reimbursement methodologies, and payer relations, is essential. The ideal candidate will have a proven track record of driving operational excellence, process optimization, and be proficient in revenue cycle technologies. Experience in specialized healthcare services, such as fertility benefits, and certifications in Lean Six Sigma or similar process improvement methodologies, are also required. The role demands a leader with exceptional analytical, communication, and leadership skills, who can effectively manage a large team and foster a culture of collaboration, ownership, and continuous improvement.

Hiring Manager Title

Chief Operating Officer

Travel Percent

Less than 10%

Functions