Vice President, Retrospective Programs

This is a fully remote position, open to applicants in Missouri.

📋 Description

• Spearhead the strategy and execution model for the enterprise retrospective program.

• Create and uphold a comprehensive operating model that delineates roles, responsibilities, performance expectations, escalation paths, and decision-making rights.

• Supervise chart retrieval operations to ensure prompt, complete, and accurate medical record collection.

• Manage retrieval and coding vendor oversight, which encompasses production performance, coding accuracy, quality monitoring, contract obligations, service-level agreements, issue resolution, corrective action plans, and ongoing improvement.

• Direct coding quality assurance initiatives, including second-level reviews, quality sampling, trend analysis, and remediation efforts.

• Collaborate with Analytics on retrospective analytics, vendor performance insights, opportunity identification, forecasting, dashboards, and reporting.

• Act as the business lead for vendor strategies, consolidation, partner evaluations, cost optimization, capacity planning, contract negotiations, performance oversight, and procurement liaison activities.

• Represent retrospective programs within enterprise governance and executive operating review forums.

• Convert intricate operational, coding, claims, and analytics information into executive-level insights, decisions, and action plans.

• Work in partnership with Claims, Encounters, Data Integrity, Compliance, Finance, Provider Engagement, local markets, Network, and Technology.

• Enhance chart-to-claim linkage, audit readiness, and sustainable program outcomes.

• Build and lead a high-performing team focused on leadership capability, operational discipline, accountability, talent development, and continuous improvement.

⛳️ Requirements

• A Bachelor's degree in Healthcare Administration, Business, Finance, Clinical Discipline, Health Information Management, Analytics, or a related field is required.

• A Master's degree in a related field is preferred.

• A minimum of 10 years of progressive healthcare leadership experience, including areas such as risk adjustment, provider engagement, clinical documentation improvement, quality, claims, vendor management, or related healthcare operations is required.

• Experience in leading enterprise programs across multiple markets and lines of business is essential.

• Proven track record of successfully leading strategic initiatives, provider-facing programs, vendor partnerships, and cross-functional teams is required.

• Strong understanding of risk adjustment methodologies, healthcare operations, provider documentation, and regulatory standards is necessary.

• Demonstrated executive leadership, communication, and stakeholder management skills are required.

• Equivalent experience gained through achievements of relevant knowledge, duties, scope, and skills reflective of this position's level will be considered.

• National payer experience is preferred.

• Experience in operations leadership, retrospective programs, coding, chart retrieval, and quality data integrity is preferred.

🏝️ Benefits

• Competitive pay.

• Health insurance.

• 401K plan.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Incentives may be included in total compensation, subject to program eligibility.