Vice President DRG | JobSetuu
RemoteOK Employer
Posted 19 hours ago • Via remoteOK.com
Description
Job Overview
- Source: RemoteOK
Job Description
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM⢠intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workersâ Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years.
Position Summary
The VP, DRG is responsible for providing leadership and supervision to the Revenue Recovery products under the Denials umbrella, including Diagnosis-Related Group (DRG & DRGV), and Medical Necessity Denials and Emergency (ED) Downgrades, for the purpose of obtaining quantifiable results and setting priorities for direct reports. Leads dedicated product and service teams across Revenue Integrity to deliver best-in-class results to clients while ensuring clinical coding integrity and regulatory compliance. The VP possesses strong leadership and communication skills and reports regularly to senior management on obstacles, challenges, and opportunities that impact the Companyâs revenue projections. The VP is accountable for developing and supporting leadership within the department, while driving operational performance, client satisfaction, and continuous improvement across Revenue Recovery.
\n- 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 key performance indicators that align with company objectives.
- Assists in setting the strategic direction of the Revenue Recovery and identifies areas of continuous improvement in conjunction with the senior leadership team.
- Oversee the development of quality and productivity metrics and benchmarks for Revenue Recovery functions based on industry standards and internal benchmarks.
- Acts as a key resource with the creation, communication, and training of process changes, and operational best practices within Revenue Recovery.
- Ensure the processes and inventory are in place to hit monthly, quarterly, and annual revenue expectations for the company.
- Responsible for hiring, staff training, and oversight, including annual goal planning, performance reviews, workload distribution, and regular monitoring of team performance. Ability to direct and motivate staff.
- Coordinate resources throughout the organization to address action plans for assigned clients and projects.
- Collaborate cross-functionally with other senior leaders to guide corporate planning, resource allocation, and strategic partnerships.
- Responsible for setting daily priorities to ensure the most impactful work is prioritized and appropriately staffed.
- Measures and monitors key performance metrics and delivers concise performance reporting to stakeholders with corrective action plans for variances when appropriate. Ensures these metrics are cascaded throughout the organization.
- Take the lead in explaining variances to management on a regular basis regarding DRG reviews, billing activity, and revenue metrics.
- Researches and analyzes operational processes and systems to identify process improvement opportunities and SOP enhancements.
- Participate in high-level client relationships and ensure client satisfaction through regular performance updates, collaboration, and resolution of escalated concerns.
- Oversee the development of training materials and evaluates trends to support onboarding, ongoing education, and quality improvement.
- Develops a high-performing team through effective leadership, coaching, and accountability to build a high-performing, scalable organizational structure.
- Maintain a current working knowledge of all related regulatory and compliance requirements (including HIPAA and coding guidelines) and ensures staff adherence through training, process updates, and policy alignment.
- Maintain a strong knowledge of DRG coding, clinical documentation, and reimbursement methodologies.
- Other duties as required
- Bachelorâs degree in health information management, Nursing, Healthcare Administration, Business, or related field required; Masterâs degree preferred.
- Active Certified Coding Specialist (CCS), RHIT, or RHIA strongly preferred.
- 7-10 yearsâ of progressive leadership experience in healthcare reimbursement, with 5+ years in clinical denials or inpatient claims environments.
- Experience working with internal teams while serving in a client facing or client support role.
- Strong understanding of inpatient coding, DRG reimbursement methodology, medical record auditing, and payer guidelines.
- Experience navigating hospital revenue cycle environments and working with large-scale data/reporting tools.
- Demonstrated ability to operate effectively at both strategic and operational levels.
- Timely and regular attendance.
- Equivalent combination of education and experience will be considered
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
- Practices and adheres to EnableCompâs Core Values, Vision and Mission.
- Travel 0-10%; general office environment
- Strong and professional written and oral communications skills.
- Has worked in a production environment and can meet deadlines. Provide examples of goals measurement for yourself and your team.
- Excellent people skills to interface with multiple internal stakeholders.
- Proven success in obtaining quantifiable results from and setting priorities for direct reports. Describe how you manage to individual goals.
- Organized and can handle multiple projects simultaneously.
- Health care experience and familiarity with payer or provider data sets.
- Ability to set and manage multiple priorities among several teams.
- Experience communicating obstacles & challenges and developing action plans to present to management. Provide examples.
EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.
EnableComp recruits, develops and retains the industry's top talent. As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people. We believe that investing in our employees is the key to our success, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies. If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you.
Donât just take our word for it! Hear what our people are saying:
âI love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other.â â Revenue Specialist
âI enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun.â â Supervisor, Operations
Expert Career Tips for Vice President DRG Roles
To succeed in a competitive market as a Vice President DRG , you need more than just technical skills. Here are some expert strategies to elevate your profile:
- Build a Strong Portfolio: For technical roles, a clean GitHub or a personal project site is essential. For non-technical roles, a case study portfolio demonstrating problem-solving and impact is equally valuable. Show, don't just tell, what you have achieved in your previous positions.
- Master the Narrative: When interviewing, use the STAR method (Situation, Task, Action, Result) to structure your answers. Quantify your results wherever possible—mentioning "increased efficiency by 20%" is much more impactful than saying "improved efficiency."
- Continuous Learning: The industry moves fast. Whether it's staying updated with the latest AI tools or mastering a new management methodology, continuous professional development is key. Consider obtaining industry-recognized certifications that align with Vice President DRG requirements.
- Networking: Connect with other professionals in similar roles. Join online communities, attend webinars, and engage in meaningful discussions on professional social networks. Often, the best opportunities come through referrals and community engagement.
- Soft Skills Matter: Communication, empathy, and leadership are often the deciding factors between two equally qualified technical candidates. Cultivate these skills as they are universally valued across all industries and seniority levels.
Additionally, research the specific company's culture and values. Tailoring your application to show how you align with their mission can significantly increase your chances of moving forward in the process.
Salary & Compensation
Salary not disclosed; typically competitive for the role.
Work Arrangement
Type: On-Site
Standard business hours at the office.
Comprehensive Application Strategy & Hiring Process
Applying for a new role is a marathon, not a sprint. Follow this strategic approach to maximize your success rate:
1. Initial Research & Tailoring
Don't send the same resume to every employer. Spend at least 30 minutes researching the company. Look for recent news, their product roadmap, and their team structure. Modify your summary and core competencies to reflect the specific keywords found in the job description.
2. The Perfect Cover Letter
If the application allows for a cover letter, use it to tell a story that your resume cannot. Explain why you are passionate about this specific company and how your unique background makes you the perfect fit for the challenges they are currently facing.
3. Navigating the Multi-Stage Interview
Most modern hiring processes involve 3-5 stages. This typically includes a recruiter screen, a technical or skill-based assessment, a peer interview, and a final leadership round. Prepare for each stage differently: focus on enthusiasm and fit for the recruiter, technical depth for the assessment, and strategic vision for the leadership round.
4. Post-Interview Follow-Up
Always send a personalized thank-you note within 24 hours of each interview. Reference a specific topic discussed during the call to demonstrate your active listening and genuine interest in the role.
By following these steps, you demonstrate a high level of professionalism and attention to detail that sets you apart from the average applicant.
Typical Interview Process
- Resume screening
- HR call
- Skill interview
- Final manager interview
- Offer
Tip: Research the company's products and culture.
Global Market Intelligence & Relocation Insights
At JobSetuu, we specialize in helping talent navigate the global job market. Here is what you need to know about the current landscape in Global and beyond:
The demand for skilled professionals is increasingly borderless. For roles based in Global, understanding the local cost of living, visa requirements (if applicable), and cultural nuances is vital. If this is a remote role, consider the time zone alignment and the asynchronous communication culture of the hiring organization.
Relocation Support: Many forward-thinking companies offer relocation packages that include moving stipends, temporary housing, and legal assistance with work permits. When evaluating an offer, look beyond the base salary—consider the total compensation package, including equity, bonuses, and healthcare benefits.
Work-Life Balance Trends: Hybrid and remote work have become standard in many regions. Research the local labor laws and common practices regarding work hours and vacation time to ensure the role aligns with your lifestyle goals.
Leveraging JobSetuu's tools can help you compare salaries across different cities and understand the "purchasing power" of your potential offer, ensuring you make an informed decision for your long-term career path.
Skills & Competency Roadmap for Professional Development
To remain competitive in Professional Development, we recommend focusing on the following core competencies over the next 12-18 months:
- Technical Mastery: Deepen your expertise in the core tools and languages relevant to your field. For developers, this might be cloud architecture; for marketers, it might be data-driven attribution modeling.
- AI Augmentation: Learn how to leverage generative AI and automation tools to increase your productivity. Understanding how to integrate these technologies into your workflow is becoming a non-negotiable skill.
- Leadership & Strategy: Even in individual contributor roles, the ability to think strategically and lead projects from inception to completion is highly valued. Focus on stakeholder management and high-level project planning.
- Data Literacy: The ability to interpret data and use it to drive decisions is essential across all business functions. Familiarize yourself with data visualization and basic analytical concepts.
By investing in these areas, you not only prepare yourself for the role you are applying for today but also build a resilient foundation for the opportunities of tomorrow.
Apply via JobSetuu
Discover your next career milestone on JobSetuu. This Vice President DRG position is part of our commitment to bringing you the most relevant and high-impact job openings globally. At JobSetuu, we simplify your job search by aggregating premier listings and providing the tools you need to stand out. Don't miss the chance to elevate your professional journey—explore more opportunities and career insights on our platform today.
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