About the Role
EnableComp is seeking a visionary and results-oriented Vice President of DRG to spearhead our Revenue Recovery products under the Denials umbrella. This executive role is critical in driving the success of our Diagnosis-Related Group (DRG and DRGV) solutions, Medical Necessity Denials, and Emergency Department (ED) Downgrades. As a key member of our leadership team, you will leverage EnableComp’s industry-leading expertise and our proprietary E360 RCM™ intelligent automation platform to deliver best-in-class results for hospitals, health systems, and ambulatory surgery centers nationwide. You will be responsible for providing high-level supervision to dedicated service teams, ensuring clinical coding integrity, and maintaining strict regulatory compliance while optimizing financial sustainability for our clients.
The successful candidate will act as a primary subject matter expert, bridging the gap between strategic corporate planning and operational execution. Reporting to senior management, the VP of DRG will communicate obstacles, challenges, and opportunities that impact revenue projections while fostering an environment of continuous improvement. EnableComp is a multi-year recipient of the Top Workplaces award and was recognized as the #1 Specialty Revenue Cycle Management Solution provider in 2024. We are looking for a leader who embodies our core values and is dedicated to fostering a culture of professional growth, innovation, and ecstatic client satisfaction. This is a remote-friendly position that requires a sophisticated understanding of the complex claims environment and a passion for navigating the evolving healthcare reimbursement landscape.
Key ResponsibilitiesAs the Vice President of DRG, you will be accountable for the overall performance and strategic direction of the Revenue Recovery division. Your core duties include:
- Serving as the Subject Matter Expert for all Revenue Integrity products, specifically DRG/DRGV reviews and Medical Necessity Denials.
- Defining and establishing departmental goals, financial targets, and key performance indicators (KPIs) that align with overarching company objectives.
- Leading and motivating dedicated product teams, ensuring proper workload distribution, annual goal planning, and regular performance monitoring.
- Developing and overseeing quality and productivity metrics based on internal benchmarks and industry standards to ensure operational excellence.
- Collaborating cross-functionally with senior leadership to guide corporate planning, resource allocation, and strategic partnerships.
- Managing high-level client relationships, delivering concise performance updates, and resolving escalated concerns to ensure long-term satisfaction.
- Identifying process improvement opportunities and enhancing Standard Operating Procedures (SOPs) through deep research and data analysis.
- Ensuring that clinical inventory and processes are optimized to meet or exceed monthly, quarterly, and annual revenue expectations.
- Maintaining a comprehensive knowledge of HIPAA, coding guidelines, and regulatory requirements to ensure total compliance across all teams.
- Providing executive-level reporting on billing activity, revenue metrics, and variances to the senior management team.
To excel in this role, candidates must possess a unique blend of clinical knowledge, financial acumen, and executive leadership skills. The requirements include:
- A Bachelor’s degree in Health Information Management, Nursing, Healthcare Administration, or a related Business field is required; a Master’s degree is strongly preferred.
- Active professional certification such as Certified Coding Specialist (CCS), RHIT, or RHIA is strongly preferred.
- 7–10 years of progressive leadership experience in healthcare reimbursement, with at least 5 years specifically focused on clinical denials or inpatient claims.
- Profound understanding of inpatient coding, DRG reimbursement methodologies, medical record auditing, and payer guidelines.
- Proven track record of obtaining quantifiable results and managing large, high-performing teams in a production-oriented environment.
- Strong communication skills with the ability to present complex data and strategic action plans to internal and external stakeholders.
- Experience navigating hospital revenue cycle environments and utilizing large-scale data and reporting tools.
- Ability to travel up to 10% as required for client meetings or corporate events.
EnableComp is committed to being the employer of choice in the RCM industry. We provide a workplace culture that empowers employees and fosters professional development. Benefits of joining our team include:
- A collaborative, remote-work environment that values work-life balance and flexibility.
- The opportunity to work with a Black Book #1 ranked industry leader and an Inc. 5000 fastest-growing company.
- Comprehensive professional growth and career development resources.
- A culture centered around core values, mutual respect, and shared goals.
- Competitive executive compensation package and performance-based incentives.
- The chance to be part of a team that is removing the burden of payment from patients and providers nationwide.