Vice President of Operations - Healthcare
Humareso has partnered with a growing Healthcare company looking for a Vice President of Operations!
Location: Canonsburg, PA - Ideally seeking a local Pittsburgh, PA candidate!
Salary 108-130k plus bonus opportunity!
As the Vice President of Operations, a successful candidate's core responsibilities:
Private Practice Operations Leadership
Lead and manage the full-service delivery operation across all three service lines: Revenue Cycle Management (RCM), Medical Software Management (MSM), and Population Health Management (PHM)
Serve as the operational authority on every dimension of successful private practice management — from the physician's clinical workflow to the front-desk registration process to the final payment posting in the billing system
Oversee the physician practice conversion program — guiding doctors who are transitioning from corporate employment or hospital-based practice into independent private practice, including credentialing, payer enrollment, EHR selection and implementation, billing setup, staffing, compliance, and operational launch
Ensure every client practice receives service delivery that is accurate, timely, compliant, and genuinely value-added at every interaction
Revenue Cycle Management Oversight
Direct oversight of the RCM team and all billing operations across the client portfolio
Ensure clean claim rates achieve and sustain industry benchmark standards (90%+)
Oversee the complete revenue cycle: charge capture, claim submission, payment posting, denial management, appeals, and secondary billing
Manage payer relationships, contract negotiations, and fee schedule benchmarking across commercial payers, Medicare, and Medicaid
Implement and enforce denial management and appeal protocols with documented escalation paths through IDR (Independent Dispute Resolution) and litigation when warranted
Establish and drive accounts receivable performance — DSO targets, AR aging thresholds, and collection rate benchmarks — with weekly reporting and accountability
Medical Coding and Compliance
Ensure the team applies CPT, ICD-10, HCPCS, and modifier codes correctly across all supported specialty types
Stay current on annual CMS fee schedule updates, CPT code changes, and new billing opportunities (including Remote Patient Monitoring, Transitional Care Management, Chronic Care Management, and behavioral health code expansions)
Establish and enforce a compliance framework — HIPAA, OIG guidelines, payer-specific billing rules — across all client accounts and internal staff
Build a quality control function that identifies coding errors and workflow breakdowns before they reach the payer
EHR and Medical Software Management
Oversee the Medical Software Management service line — supporting client practices on the major EHR platforms including Medent, ModMed, eClinicalWorks, NextGen, Micro MD, athenahealth, and others
Direct the development and maintenance of platform-specific workflow documentation, staff training, and client onboarding protocols for each supported EHR system
Ensure no new client is onboarded on a platform for which the organization does not have internal staff competency — enforce mandatory pre-contract feasibility checks
Evaluate and integrate AI-assisted documentation tools (ambient AI, coding automation) across client practices and internal operations
Population Health Management
Partner with the PHM Manager to grow the population health service line in alignment with value-based care contracts, shared risk programs, and payer-driven quality incentive models
Support the operationalization of PHM services for primary care practices participating in Highmark and UPMC shared risk networks
Ensure PHM reporting, data sharing, and client education workflows are documented, repeatable, and consistently executed
People and Team Management
Lead, manage, and develop a distributed remote team of billing specialists, software managers, population health coordinators, and subcontracted staff
Establish structured performance management: clear role expectations, measurable KPIs, regular one-on-ones, quarterly reviews, and annual merit evaluations
Build and maintain a skills matrix across all staff — identifying single points of failure and ensuring cross-training and documented coverage plans for every critical function
Manage remote workforce accountability with clear work standards, output metrics, and communication protocols
Systems, Process, and Technology
Build the standard operating procedures currently lacking — documented workflows for every core process: new client onboarding, billing cycle management, denial handling, software implementation, client offboarding, and staff handoffs
Implement and manage the company's operating cadence: weekly team meetings, monthly performance reviews, quarterly planning cycles, and annual budgeting
Develop the operations plan for the migration to cloud-based infrastructure and AI-integrated workflows across billing, documentation, and internal operations
Optimize the use of Microsoft 365 across the team — Teams, SharePoint, OneDrive, Excel, and Outlook — as the core productivity and communication platform
Maintain and expand the use of Monday.com as the OKR, project management, and team accountability platform
Financial Management
Own the company's operating P&L with full budget authority and accountability for revenue, cost of delivery, gross margin, and EBITDA
Build the company's first formal annual operating budget — including headcount planning, technology investment, partner costs, and merit budgets — and manage against it monthly
Develop client-level profit and loss statements to identify which client relationships are profitable on a fully loaded basis and which are not
Enforce financial policy consistently — including the management of accounts with overdue balances — without exception for relationship considerations
Partner with the Controller on weekly cash position reporting, DSO monitoring, and AR performance management
Goal Setting and Accountability
Define and implement functional KPIs for every team role — measurable, time-bound, and directly connected to company revenue and client retention
Run a weekly leadership accountability review using the commitment table format from strategic planning sessions
Ensure the company's OKR framework (Monday.com) reflects current strategic priorities and is actively used by all team members, not just leadership
Minimum Qualifications
10+ years of progressive experience in private practice healthcare operations, revenue cycle management, physician practice management, or health information technology — not hospital administration
Minimum 5 years in a senior operational leadership role directly managing a team of 15 or more people in a healthcare services environment
Deep billing expertise — working knowledge of CPT, ICD-10, HCPCS, and modifier coding; denial management; payer appeal processes; EOB and ERA reconciliation; clearinghouse operations; and Medicare/Medicaid billing requirements
Proven P&L ownership — direct budget accountability, forecasting, and financial management in a services business
EHR platform knowledge — hands-on experience with two or more of the following: Medent, eClinicalWorks, NextGen, ModMed, athenahealth, Micro MD, AdvancedMD, or equivalent platforms
Remote workforce leadership — documented experience managing geographically distributed teams with structured accountability, output metrics, and communication systems
Microsoft 365 proficiency — Teams, SharePoint, OneDrive, Excel, Outlook, and Word used as daily operational tools
SOP and process documentation experience — has built operational manuals, training curricula, and workflow documentation from scratch in a prior role
Private practice conversion knowledge — experience supporting physicians transitioning from employment or hospital-based practice into independent practice, including payer enrollment, credentialing, EHR selection, and operational launch
Population health familiarity — working knowledge of value-based care models, quality incentive programs, and chronic care management billing
Preferred Qualifications
Active membership in
Familiarity with Professional Coder (CPC), or Certified Revenue Cycle Professional (CRCP)
Experience with the No Surprises Act (NSA) and Independent Dispute Resolution (IDR) process
Familiarity with Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) billing under 2024–2026 CMS guidelines
Familiarity with selecting, implementing, or integrating ambient AI documentation tools
Prior experience in a company with revenue between $3M and $15M — understands the discipline required at this scale
MBA, MHA, or equivalent graduate degree preferred
- Location
- Canonsburg, PA
About Humareso
At Humareso, we don’t just do HR - we energize it.
We’re your people-powered strategy partners – bringing our real-world expertise to help your business thrive. But we’re more than just a check-the-box HR playbook. With a human-centered approach and deep expertise, we develop smart, scalable plans for managing talent and crafting long-term HR strategies, working with you to ensure that culture and strategy work hand in hand. And, with our award-winning HRO solutions, we can also take the stress out of payroll, HR compliance, benefits, recruiting, and employee relations so that you can handle the business of your business!
From strategic planning to hands-on HR administration, we help businesses not only navigate today’s workplace but also build a future-ready foundation. Whether you need big-picture thinking or day-to-day HR support, we’re here to build a customized solution that keeps your people – and your business - moving forward.