Vice President, Tranformation Services - Denials Prevention

Job Purpose

The Vice President, Transformation Services- Denials Prevention is responsible for leading enterprise-wide transformation strategies that prevent avoidable denials, protect revenue yield, and drive top-tier revenue cycle performance across health system clients. This role uses analytics, payer intelligence, operational assessments, and root-cause analysis to identify revenue leakage and translate findings into actionable changes across the revenue cycle.

The VP partners with client executives and internal operational, clinical, and analytics teams to move the organization from reactive denial recovery to proactive prevention, ensuring interventions are implemented at the point in the revenue cycle where the denial originates. Success is measured through sustainable reductions in preventable denials and write-offs, improved first-pass payment and clean claim performance, increased net revenue yield, and achievement of top-tier performance benchmarks.

Duties and Responsibilities

• Lead enterprise-wide denial prevention strategy and transformation across hospital revenue cycle operations.
• Identify and quantify opportunities to improve revenue yield by preventing avoidable revenue leakage before claims are submitted.
• Analyze denial, write-off, payer, and reimbursement data to identify root causes, emerging trends, and high-value transformation opportunities.
• Establish a comprehensive denial prevention framework that shifts organizational focus from denial recovery to upstream prevention and first-pass payment.
• Develop prioritized transformation strategies based on financial impact, preventability, payer trends, operational performance, and implementation feasibility.
• Drive performance toward top-tier industry benchmarks for initial denial rate, preventable denials, clean claim performance, denial write-offs, overturn rates, and first-pass payment.
• Lead root-cause initiatives across Patient Access, Pri