Leads pre-sales solution strategy for healthcare revenue cycle management engagements. Partners with Sales, Operations, Technology, Finance, and executives to conduct discovery, design scalable operating models, develop pricing and ROI analyses, respond to RFPs, and present solutions to enterprise healthcare prospects. Oversees solution architecture, workforce and delivery-model planning, transition strategies, contract scope, and profitability assessments while applying deep RCM, regulatory, and healthcare BPO expertise.
Job Summary:
The Vice President, Pre-Sales & Solutions is responsible for leading solution strategy and design in support of new business development and growth initiatives within the healthcare revenue cycle management (RCM) sector. This role partners closely with Sales, Operations, Technology, Finance, and executive leadership to develop customized, scalable, and profitable solutions for prospective clients. The VP will lead to discovery sessions, solution development, pricing strategy, RFP responses, and executive presentations, ensuring proposed solutions align with client needs, operational capabilities, and company financial objectives. This position serves as a trusted advisor throughout the sales cycle, leveraging deep RCM expertise to drive competitive differentiation and support successful business outcomes.
Supervisory Responsibilities:
This position has direct supervisory responsibilities.
Duties/Responsibilities:
- Lead discovery sessions with prospective clients to understand revenue cycle challenges, business objectives, and operational requirements. Develop tailored solutions that align with client goals and Access Healthcare's service capabilities.
- Partner with Sales, Operations, Technology, and Product teams to design scalable, competitive solutions that support new business acquisition while meeting profitability and margin objectives.
- Serve as the executive solution lead during RFPs, prospect meetings, finalist presentations, and due diligence sessions.
- Partner with Sales leadership to support strategic pursuits and enterprise opportunities.
- Participate in prospect discovery meetings and executive-level presentations.
- Translate client business needs into customized RCM solutions.
- Lead the development of operational, technology, and staffing models for prospective clients.
- Design end-to-end RCM solutions including workflow optimization, automation opportunities, offshore/onshore delivery models, and performance improvement strategies.
- Develop pricing models that meet client expectations while achieving company profitability targets.
- Collaborate with Finance and Operations to validate assumptions and margin forecasts.
- Support contract negotiations and scope development.
- Lead solution responses for RFPs, RFIs, and proposal submissions.
- Develop compelling business cases and ROI models that demonstrate client value.
- Stay informed on competitive offerings, industry trends, regulatory changes, and healthcare revenue cycle innovations.
- Provide market insights to support growth strategies and solution development
- Performs other duties as assigned.
Required Skills/Abilities:
- Must possess and maintain an active Certified Professional Coder (CPC) credential through AAPC or Certified Coding Specialist (CCS) credential through AHIMA.
- Extensive experience supporting healthcare BPO and RCM sales pursuits.
- Strong expertise in solution architecture and operating model design.
- Proven experience developing pricing models and financial business cases.
- Ability to lead executive-level presentations and proposal defenses.
- Experience responding to large-scale healthcare RFPs and enterprise opportunities.
- Strong understanding of transition planning and implementation strategies.
- Demonstrated ability to balance client requirements with operational feasibility and profitability.
Education and Experience:
- Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, Healthcare Management, or a related field required.
- MBA, MHA, or other advanced degree preferred.
- Must possess and maintain an active Certified Professional Coder (CPC) credential through AAPC or Certified Coding Specialist (CCS) credential through AHIMA.
- 15+ years of experience in healthcare revenue cycle management, healthcare consulting, healthcare technology, or healthcare BPO environments.
- 10+ years of experience supporting enterprise healthcare sales pursuits, solution design, consulting engagements, or client strategy initiatives.
- Proven experience developing and presenting customized RCM solutions for healthcare providers, health systems, physician groups, and payer organizations.
- Extensive experience leading solution architecture, operating model design, workforce planning, and service transformation initiatives.
- Demonstrated success supporting large-scale RFPs, RFIs, proposal responses, and executive-level sales presentations for multi-million-dollar healthcare outsourcing engagements.
- Strong experience developing pricing models, financial analyses, business cases, and profitability assessments to support new business opportunities.
- Experience designing and implementing onshore, offshore, and hybrid delivery models within healthcare BPO and revenue cycle operations.
- Deep knowledge of end-to-end revenue cycle processes, including Patient Access, Coding, Clinical Documentation Improvement (CDI), Accounts Receivable, Denials Management, Payment Posting, and Revenue Integrity.
- Experience collaborating with Sales, Operations, Technology, Product, and Finance teams to develop scalable and competitive client solutions.
- Proven ability to communicate complex operational, financial, and technology concepts to executive stakeholders and healthcare leadership teams.
- Prior experience with organizations such as Access Healthcare, AGS Health, IKS Health, GeBBS Healthcare Solutions, Omega Healthcare, Optum, Guidehouse, Huron, Alvarez & Marsal, or similar healthcare consulting and outsourcing organizations is strongly preferred.
- Strong understanding of healthcare regulatory requirements, HIPAA compliance, payer-provider dynamics, and industry trends impacting revenue cycle operations.
- Experience supporting healthcare outsourcing contracts valued at $10M+ annually.
- Experience leading finalist presentations and proposal defenses with C-suite healthcare executives.
- Knowledge of automation, AI, analytics, workflow optimization, and digital transformation initiatives within revenue cycle management.
- Lean Six Sigma, PMP, HFMA, or other relevant certifications preferred.
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