V-Soft Consulting Group, Inc. · 8 hours ago
AVP - Out of Network Operations - Remote
United States
Full-time
Remote
Director/Executive
10+ years expV-Soft Consulting Group, Inc. is currently hiring for an AVP - Out of Network Operations. The role is responsible for managing revenue-generating operations within the company, leading strategic initiatives, and ensuring compliance with regulatory frameworks in healthcare operations.
Artificial Intelligence (AI)ConsultingInformation TechnologySoftware
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
Qualification
Required
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
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
Knowledge of health care and managed care products
Excellent communication, leadership, planning, analytical, and organizational skills
Ability to travel 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
Benefits
Medical
Dental
Vision
401(k) plan
Competitive compensation
Company
V-Soft Consulting Group, Inc.
V-Soft Consulting, an innovative corporation specializing in Information Technology consulting; including staffing, digital, and infrastructure solutions.
1001-5000 employees
H1B Sponsorship
V-Soft Consulting Group, Inc. has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (363)
2024 (248)
2023 (272)
2022 (401)
2021 (409)
2020 (460)
Funding
Current Stage
Late StageLeadership Team
Michael Grendi
Chief Financial Officer
Lonnie Gray
Chief Operating Officer
Company data provided by crunchbase