Vice President, Delivery Operations

Job description

As the Vice President, Delivery Operations for PRI's Independent Dispute Review Entity (IDRE) division, you will be at the helm of the daily operations of a 150+ person, rapidly growing business unit that navigates a critical and exciting market.
You will be responsible for scaling the dispute arbitration, eligibility, and customer service departments and developing a management team comprising multiple levels of experienced and up-and-coming management talent. In this position, you will own the operating results of PRI's key business unit, delivering timely and high-quality dispute arbitration and claims eligibility decisions that complies with the standards of the No Surprises Act, and handling thousands of time-sensitive inquiries from stakeholders.
This high-impact leadership role demands exceptional operational acumen, a relentless drive to achieve performance metrics, extreme levels of leadership agility to handle a high growth and quickly changing area, the ability to develop management talent and bring the most out of people, and the leadership to guide a large team in a high-pressure environment.
In this role, you will be an integral strategic partner reporting directly to the General Manager of the IDRE division and will be deeply engaged with PRI's CEO and Executive Leadership team. You will be responsible for designing and scaling the arbitration, eligibility, and customer service areas, which have over 120 employees combined and will grow to 200 in 2026.
You will set the tone for our operational leadership, develop a team of managers and supervisors, lead the operation through a major shift to a new software platform, and have a direct impact on the overall direction of the business unit.
This is the perfect role for a results-driven leader with a proven track record of quickly scaling operations, building high-performing teams, and delivering consistent outcomes at scale. You should be coming from a service operations management environment involving knowledge workers in healthcare claims, appeals, utilization management, revenue cycle or a similar compliance driven space. You should thrive on growth and change, and have a comfort with uncertainty, as we are scaling very quickly and building systems as we go.
Success in this role will lead to greater responsibility, including management of key stakeholder relationships and the potential opportunity to lead the entire business unit.
Reports directly to the Executive Director of the Independent Dispute Resolution division and will have constant interaction with the Executive Leadership Team. Serves as one of two VPs in the division.
KEY RESPONSIBILITIES
Daily Operations Management: Oversee and manage the end-to-end daily operations of arbitrations, ensuring high-quality and compliant decisions, efficient workflow, timely processing, and adherence to all established procedures and service level agreements.
Team Leadership and Development: Lead, mentor, and develop a large team of health dispute arbitration professionals including managers and supervisors, fostering a high-performance culture, ensuring strong engagement, and providing the necessary guidance and support in a demanding environment.
Strategy and Operational Design: Design and implement best in class operations, optimize workflows, and identify and execute on initiatives to improve performance.
Performance and Metric Attainment: Drive the team to consistently achieve and exceed key performance indicators (KPIs) and operational metrics, implementing corrective actions and optimizations as needed to maintain high output and quality standards.
Efficiency Improvement and Process Optimization: Continuously identify bottlenecks and inefficiencies within daily operations, leading initiatives to streamline processes, leverage technology, and implement best practices to enhance productivity and reduce costs.
Resource Allocation and Management: Strategically manage staffing, resources, and workloads to ensure optimal utilization, balance operational demands, and maintain capacity for sustained high-volume processing.
Risk Mitigation and Problem Solving: Proactively identify and address operational risks and challenges, implementing effective solutions to minimize disruptions, errors, and ensure business continuity.
Cross-functional Collaboration: Work closely with the Center of Excellence, technology, finance, and other internal teams to ensure operational alignment, seamless integration of new processes/tools, and consistent delivery of program objectives.
Stakeholder Management: Present observations, results, and plans to the Executive Leadership Team.
Bachelor's degree required, preferably in Business Administration, Healthcare Administration, Operations Management, or a related field. Master's degree highly preferred.
Experience: A track record of progressive leadership experience in high-volume (thousands per day), high-growth operational environments, with at least five (5) years directly managing large divisions (50+ individuals) with multiple levels of management reports. Track record of scaling teams over 50% per year while consistently hitting challenging metrics and driving significant operational efficiencies. Demonstrated success in healthcare claims processing, medical coding, revenue cycle management, insurance appeals, utilization management, or medical case review operations is essential.
Skills: Exceptional leadership, organizational, and problem-solving skills, with a strong ability to manage complex logistics and drive results under pressure and through relentless change. Superior analytical abilities to interpret performance data and implement data-driven solutions. Excellent communication (verbal and written) and interpersonal skills for motivating large teams and engaging stakeholders. Proficiency in operational management software and performance tracking tools.
Competencies: Possesses a results-oriented mindset with an unwavering focus on execution, strong decision-making capabilities, a penchant for building systems and driving performance in quickly changing and scaling environments, and the ability to lead and develop high-performing teams, all while demonstrating strong integrity and adaptability.
Other Requirements: Ability to obtain and maintain U.S. Government Security Clearance.
COMPENSATION
A competitive cash package including base salary and bonus.

About PROVIDER RESOURCES INC

Join Provider Resources (PRI) and Make an Impact in Healthcare!
At PRI, we're passionate about driving integrity and advancing quality across the healthcare system. As a trusted leader in the industry, we're tackling some of healthcare's biggest challenges-improving compliance, advancing health equity, and enhancing quality and clinical outcomes while helping organizations improve care delivery and create meaningful change.
We believe that people are at the heart of healthcare, and focus on scalable, person-centered strategies that prioritize clinical excellence and evidence-based practices. Our work supports a broad network of stakeholders, including providers, patients, caregivers, payers, and regulators. We strive to enhance experiences, improve outcomes, and foster a healthier future for all.
If you're looking to be part of a forward-thinking team that makes a difference, PRI is the place for you!