Vice President

• Develop high-quality business strategies and operational plans aligned with Gainwell’s short-term and long-term objectives for the solution offering
• Oversee payment integrity delivery operations to drive revenue growth, margin expansion, and client satisfaction
• Lead and motivate team members, develop a high-performing managerial team, and partner cross-functionally with Finance, Account Management, Sales, Engineering, and Implementations
• Manage pre-payment and post-payment payment integrity solutions, including Clinical Claim Reviews, Payment Analytics/Data Mining, FraudCapture, Utilization Review, Long-Term Care, and Credit Balance
• Develop, manage, and attain revenue and expense budget goals
• Manage product portfolio development plans with technical development partners in alignment with client needs and revenue forecasting
• Monitor systems and processes that identify and mitigate payment integrity revenue portfolio opportunities and risks
• Apply advanced financial analysis and forecasting techniques to project and optimize revenue
• Collaborate with the VP Product on product expansion and annual revenue targets
• Partner with the AI development team on projects improving efficiency, accelerating growth, and speeding go-to-market solutions
• Represent the company in pre-sales solutioning efforts and collaboratively design solutions with Gainwell SGMs and HMS SVP Client Management
• Partner with clinical operations on demand, capacity, and compliance with client SLAs and contract requirements
• Oversee RFP and new business proposal reviews for strategic fit and implementation, operational, and financial success
• Improve product quality through defect identification, root cause analysis, and corrective action project management
• Improve internal product processes through Lean and AI-driven continuous quality improvement methodologies
• Manage staffing planning and workforce management tools across the delivery team
• Build operational metrics covering service efficiency, quality, cost per unit, productivity, staffing to demand, appeals, and analytics efficacy
• Coordinate with the product implementation team on solution architecture and end-to-end project management of new implementations
• Communicate product strategy, financial results, operational status, and quality/compliance issues to company leadership
• Lead delivery teams through regular communication, recognition, and quarterly Town Hall meetings
• Direct leadership development and training, including bench strength and succession planning
• Participate in talent and succession management review sessions as a Talent Management champion

Vice President jobs in Wisconsin

Vice President, Payment Integrity