Overview
Remote
Depends on Experience
Full Time
Skills
NETWORK+
External-facing experience with clients
regulators
and legal entities in large-scale healthcare operations. Knowledge of health care and managed care products. Excellent communication
leadership
planning
analytical
and organizational skills.
Job Details
AVP - Out of Network Operations – Remote
V-Soft Consulting is currently hiring for a AVP - Out of Network Operations – Remote for Naperville, Illinois.
Education and Experience »
Knowledge, Skills and Abilities »
WHAT YOU’LL DO:
Job Responsibilities:
Interested?
Qualified candidates should send their resumes to bpritchett@vsoftconsulting.com
V-Soft Consulting Group is recognized among the top 100 fastest growing staffing companies in North America, V-Soft Consulting Group is headquartered in Louisville, KY with strategic locations in India, Canada and the U.S. V-Soft is known as an agile, innovative technology services company holding several awards and distinctions and has a wide variety of partnerships across diverse technology stacks.
As a valued V-Soft Consultant, you’re eligible for full benefits (Medical, Dental, Vision), a 401(k) plan, competitive compensation and more. V-Soft is partnered with numerous Fortune 500 companies, exceptionally positioned to advance your career growth.
V-Soft Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
For more information or to view all our open jobs, please visit www.vsoftconsulting.com or call (844) 425-8425.
#LI-BP2
#MonsterPost
V-Soft Consulting is currently hiring for a AVP - Out of Network Operations – Remote for Naperville, Illinois.
Education and Experience »
- Minimum bachelor’s degree in a relevant field coupled with 10 years’ experience in an operational management/leadership role, at least 7 years of which should include healthcare markets (insurance companies, TPA, HMO, or managed care).
- Deep understanding of regulatory and legal frameworks impacting large healthcare organizations.
- Proven experience partnering on technical roadmaps and driving technology-enabled operational strategies.
- Strong appeal and negotiation skills for resolving escalations and influencing outcomes.
Knowledge, Skills and Abilities »
- Demonstrated ability to collaborate effectively with internal support teams and external stakeholders.
- External-facing experience with clients, regulators, and legal entities in large-scale healthcare operations.
- Direct the budget process and financial planning for assigned cost center(s), balancing cost containment with department needs and customer satisfaction. Serve as a business sponsor for Agile application development projects and other associated client implementation initiatives. Select, develop, and evaluate staff to ensure efficient operation of the department, fostering engagement and performance across teams of 50–100+. Ensure compliance with HIPAA regulations and requirements. Demonstrate Company’s Core Competencies and values. Other duties as assigned.
- Knowledge of health care and managed care products. Excellent communication, leadership, planning, analytical, and organizational skills.
- Ability to travel as needed.
WHAT YOU’LL DO:
Job Responsibilities:
- Position leads, plans, develops, and directs aspects of respective cost centers, functions, and/or processes within the Referenced Based Pricing (RBP) department.
- The AVP is accountable for managing revenue-generating operations within the company, partnering on the technical/product roadmap, and driving strategic initiatives that require exceptional leadership and external-facing collaboration role demands strong operational expertise, deep healthcare knowledge, and the ability to navigate complex regulatory environments.
- Regularly communicate with organizational leadership on performance, risks, opportunities, and program updates. Maintain awareness of regulatory changes and proactively update operations and roadmaps as needed.
- Proven track record of managing high revenue streams within an organization.
- Strong leadership experience in building and scaling teams
- Extensive experience handling client escalations and navigating litigation issues within healthcare operations.
Interested?
Qualified candidates should send their resumes to bpritchett@vsoftconsulting.com
V-Soft Consulting Group is recognized among the top 100 fastest growing staffing companies in North America, V-Soft Consulting Group is headquartered in Louisville, KY with strategic locations in India, Canada and the U.S. V-Soft is known as an agile, innovative technology services company holding several awards and distinctions and has a wide variety of partnerships across diverse technology stacks.
As a valued V-Soft Consultant, you’re eligible for full benefits (Medical, Dental, Vision), a 401(k) plan, competitive compensation and more. V-Soft is partnered with numerous Fortune 500 companies, exceptionally positioned to advance your career growth.
V-Soft Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
For more information or to view all our open jobs, please visit www.vsoftconsulting.com or call (844) 425-8425.
#LI-BP2
#MonsterPost
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.