Job description

About the company

The organization supports clients in improving their financial outcomes through the reimbursement cycle. Its work combines scalable service models with clinical expertise to address program needs, while analytics and technology help guide decisions and keep performance aligned with goals.

The company also emphasizes long-term career growth, with a focus on investing in employees’ development and creating an environment that supports both professional advancement and personal growth.

Role overview

The Senior Director of Clinical Denials is centered on quality assurance, continuous process improvement, and protecting client health and satisfaction. The position is accountable for meeting production and quality targets across clients while also supporting positive morale and the development of staff.

This is a remote role for candidates based in the United States only. Travel is required quarterly for visits to client locations and the New Jersey office for team meetings.

Key responsibilities

The role works closely with senior leadership to ensure client expectations are met and that team performance remains strong.

Partner with the AVP to support client needs and expectations.
Collaborate with managers and supervisors to keep employee engagement, performance, and development as top priorities.
Help shape, document, and refine policies and working guidelines that support strong performance.
Assist the AVP with client-facing activities, including preparing and presenting reporting materials.
Monitor production, quality, and effectiveness metrics, and share feedback with team members promptly and clearly.
Lead timely execution of special projects that support client quality and health.
Coach supervisors on performance management, including action planning and constructive handling of performance concerns.
Review and align audit practices to maintain strong quality control.
Keep leadership informed about team performance and areas where improvement is needed.
Work with leadership to ensure best-in-class training practices are carried out.
Take on other assigned duties as needed.

Requirements

Applicants should bring hands-on leadership experience in a healthcare revenue cycle environment, along with strong communication and client management capabilities.

Minimum of 5 years of relevant experience, including direct people management.
Prior client-facing experience on the provider side of healthcare.
Mandatory background in denials management on the provider side of healthcare.
DRG downgrade experience is strongly preferred.
Solid understanding of the revenue cycle management industry.
Experience leading a remote hourly workforce is preferred.
Working knowledge of Outlook, Word, and PowerPoint for email, scheduling, document creation, and presentations.
Intermediate Excel capability, including vlookup, sumif, countif, pivot tables, and basic formulas.
Strong organizational, analytical, problem-solving, critical-thinking, conflict-resolution, and management skills.
Ability to work well both independently and as part of a team.
Good active listening skills and the ability to communicate clearly in speaking and writing.
Ability to plan work, organize tasks, and distribute assignments effectively.
Ability to train, coach, guide, motivate, and develop team members.

Additional information

The job outline is meant to describe the core scope of the role, but it is not a complete list of every possible duty. Other responsibilities or requirements may be assigned by supervisors when appropriate.

Physical demands

The role requires regular hand-eye coordination and manual dexterity to use office equipment. Candidates must be able to work at a computer for 6 to 8 hours per day and function in an environment with frequent interruptions. The position may involve prolonged sitting at times and occasionally lifting or moving materials up to 20 lbs. The work can also involve higher stress during busy periods and when several deadlines overlap.

Sr Director, Clinical Solutions