Vice President, DRG (Healthcare)

TL;DR

Vice President, DRG (Healthcare): Leading Revenue Recovery products under the Denials umbrella with an accent on Diagnosis-Related Group (DRG) and Medical Necessity Denials. Focus on driving operational performance, ensuring clinical coding integrity, and optimizing financial sustainability for healthcare organizations.

Location: Remote (United States)

Company

hirify.global provides Specialty Revenue Cycle Management solutions for healthcare organizations leveraging its E360 RCM intelligent automation platform.

What you will do

• Lead Revenue Recovery products, including DRG, DRGV, Medical Necessity Denials, and ED Downgrades.
• Define departmental goals, financial targets, and KPIs aligned with company objectives.
• Oversee the development of quality and productivity metrics based on industry standards and internal benchmarks.
• Manage hiring, staff training, and performance reviews for the Revenue Integrity team.
• Collaborate cross-functionally with senior leaders to guide corporate planning and resource allocation.
• Manage high-level client relationships and resolve escalated concerns to ensure satisfaction.

Requirements

• Bachelor’s degree in Health Information Management, Nursing, Healthcare Administration, or Business.
• Active Certified Coding Specialist (CCS), RHIT, or RHIA certification strongly preferred.
• 7-10 years of progressive leadership experience in healthcare reimbursement.
• 5+ years of experience in clinical denials or inpatient claims environments.
• Strong understanding of inpatient coding, DRG reimbursement methodology, and payer guidelines.
• Must be based in the United States.

Nice to have

• Master’s degree in a related field.

Culture & Benefits

• Multi-year recipient of the Top Workplaces award.
• Strong focus on professional growth, employee development, and investing in staff.
• Flexible, family-oriented environment that values work-life balance.
• Remote work arrangement with minimal travel (0-10%).