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VP, Bill Review Operations

Role overview

Qualifications

  • 10+ years of progressive leadership experience in healthcare operations, payment integrity, revenue cycle, bill review, managed care, or a related operational environment.
  • 5+ years of senior leadership experience leading multiple functions through Directors or other senior leaders.
  • Strong business and financial acumen with experience using performance metrics and data to set priorities, make decisions, and improve results.
  • Bachelor’s degree in Business Administration, Healthcare Administration, Finance, Operations Management, or a related field.

Responsibilities

  • Lead the Bill Review Services organization with accountability for operational performance, service delivery, financial results, and achievement of departmental objectives.
  • Partner with the EVP, Payment Integrity to establish strategic direction, annual operating priorities, and long-term growth plans for Bill Review Services.
  • Build a high-performing leadership culture centered on ownership, collaboration, sound decision-making, and continuous improvement.
  • Drive execution of strategic initiatives by aligning leaders and resources, resolving competing priorities, removing barriers, and maintaining accountability for results.

Key facts

  • Remote from: Brazil
  • Full time
  • Expert & Leadership (>10 years)
  • English

Other skills

  • Leadership
  • Communication
  • Collaboration

About the company

Vālenz® logo

Vālenz®

Digital Health & Health Tech

Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development, the validation, integrity and accuracy (VIA) of claims, and a suite of risk affinity solutions. Visit our website to learn more about how Valenz engages early and often for smarter, better, faster healthcare.

Company details

Company typeSME
IndustryDigital Health & Health Tech
Company size201 - 500

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Job description

Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible.

About This Opportunity: As the VP, Bill Review Operations, you will lead the Bill Review Services organization, setting operational priorities and ensuring successful execution of business objectives in partnership with the EVP, Payment Integrity. You will oversee the operational and financial performance of the organization while building and developing a high-performing leadership team and creating an environment of accountability, collaboration, sound decision-making, and operational excellence.
In this role, you’ll balance client needs, financial performance, operational outcomes, and growth priorities while partnering across the organization to remove barriers, strengthen capabilities, and position Bill Review Services for scalable, sustainable success.

Things You’ll Do Here:

  • Lead the Bill Review Services organization with accountability for operational performance, service delivery, financial results, and achievement of departmental objectives.
  • Partner with the EVP, Payment Integrity to establish strategic direction, annual operating priorities, and long-term growth plans for Bill Review Services.
  • Set organizational priorities and make strategic decisions around resources, structure, capacity, and business tradeoffs to optimize performance and support growth.
  • Lead, coach, and develop senior leaders, establishing clear expectations and accountability for operational, financial, quality, and client outcomes.
  • Build a high-performing leadership culture centered on ownership, collaboration, sound decision-making, and continuous improvement.
  • Oversee the operational and financial health of Bill Review Services through regular review of key performance indicators, service levels, quality outcomes, budgets, and other measures of organizational performance.
  • Drive execution of strategic initiatives by aligning leaders and resources, resolving competing priorities, removing barriers, and maintaining accountability for results.
  • Partner with executive and cross-functional leaders to align operational strategy with organizational priorities, client commitments, technology initiatives, and business growth.
  • Anticipate operational risks, capacity constraints, and emerging business needs, developing strategies that strengthen performance and support sustainable growth.
  • Build organizational capability through succession planning, leadership development, workforce planning, and organizational design.
  • Serve as the executive operational leader for Bill Review Services in client executive meetings, enterprise initiatives, and cross-functional leadership discussions.
  • Champion operational excellence by empowering leaders to solve complex business challenges, identify opportunities, and continuously improve organizational performance.
Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

What You’ll Bring to the Team:
  • 10+ years of progressive leadership experience in healthcare operations, payment integrity, revenue cycle, bill review, managed care, or a related operational environment.
  • 5+ years of senior leadership experience leading multiple functions through Directors or other senior leaders.
  • Proven success leading complex operations through growth, transformation, or organizational scaling while driving strong operational and financial performance.
  • Strong business and financial acumen, with experience using performance metrics and data to set priorities, make decisions, and improve results.
  • Demonstrated ability to build, develop, and hold high-performing leadership teams accountable.
  • Strong executive presence and communication skills, with the ability to influence and collaborate across functions and with senior stakeholders.
  • Bachelor’s degree in Business Administration, Healthcare Administration, Finance, Operations Management, or a related field.
A plus if you have:
  • Experience in payment integrity, bill review, claims processing, workers’ compensation, group health, or related healthcare services.
  • Master’s degree (MBA, MHA, or similar).

Where You’ll Work: This is a fully remote position, and we’ll provide all the necessary equipment!
  • Work Environment: You’ll need a quiet workspace that is free from distractions.
  • Technology: Reliable internet connection—if you can use streaming services, you’re good to go!
  • Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software.
  • Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.
 

Why You'll Love Working Here

Valenz is proud to be recognized by Inc. 5000 as one of America’s fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare. With this commitment, you’ll find an engaged culture – one that stands strong, vigorous, and healthy in all we do.
 

Benefits

  • Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
  • Spending account options: HSA, FSA, and DCFSA
  • 401K with company match and immediate vesting
  • Flexible working environment
  • Generous Paid Time Off to include vacation, sick leave, and paid holidays
  • Employee Assistance Program that includes professional counseling, referrals, and additional services
  • Paid maternity and paternity leave
  • Pet insurance
  • Employee discounts on phone plans, car rentals and computers
  • Community giveback opportunities, including paid time off for philanthropic endeavors

At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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