AVP RCM Strategy & Analytics

Posted 3 Hours Ago
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Hiring Remotely in United States
Remote
Senior level
Biotech
The Role
The AVP RCM Strategy & Analytics leads RCM strategy, data analytics, and program management to enhance reimbursement performance and accountability across healthcare initiatives.
Summary Generated by Built In

Baylor Genetics advances precision diagnostics by delivering trusted insights that improve patient care and outcomes.
The AVP, RCM Strategy & Analytics establishes and leads a high impact strategy, analytics, and program management function that improves reimbursement performance, strengthens ASP predictability, and drives disciplined execution across Revenue Cycle Management (RCM) and Market Access priorities.

This leader brings structure to ambiguity, connects data from disparate sources into insights ready for decisions, and establishes operating rhythms that translate priorities into measurable progress. The role owns KR and KPI governance, dashboards, and executive reporting; proactively identifies risks (payer risk, ASP trends, coverage gaps); and provides PMO enablement to keep initiatives aligned, on time, and outcome driven.

Key Responsibilities / Duties and Responsibilities

Strategy, Prioritization & Operating Model Leadership

  • Establish and continuously evolve a clear operating model for RCM strategy, analytics, and initiative execution (prioritization, decision rights, roles and responsibilities, and operating rhythms).
  • Partner with senior leaders to align reimbursement priorities to enterprise goals (e.g., ASP, coverage, Medicaid expansion, cash) and ensure priorities are communicated clearly and translated into execution plans.
  • Identify operational hotspots, execution risks, and bottlenecks; drive resolution and escalation across functions where needed.

Analytics, Dashboards and Executive Reporting (KR and KPI Governance)

  • Own KR and KPI reporting, dashboards, and executive reporting to improve decision making and track payer performance end to end.
  • Proactively flag payer risks, ASP trends, and coverage gaps and translate findings into clear executive level insights and recommended actions.
  • Define and track key performance metrics and establish recurring reporting that surfaces trends, risks, and progress against goals.

Program Management Enablement (PMO) for RCM & Market Access

  • Provide PMO support for RCM and Market Access initiatives to keep projects aligned, on time, and driving measurable improvement.
  • Build and run core business forums (e.g., weekly scorecards, standups, monthly executive summaries) that reinforce accountability and execution discipline.
  • Establish transparent action plans and scorecards that create shared visibility across stakeholders and accelerate delivery.

Data Governance, Claims and Configuration Analytics, and CPT Level Rigor

  • Oversee the structuring, governance, and accessibility of reimbursement and claims datasets to enable consistent reporting and reduce operational risk.
  • Drive analytics and governance across payer configuration and mapping, including mapping at the CPT level and authorization level, reporting standardization, and controls aligned to compliance needs.
  • Ensure the organization can reliably analyze payer and CPT reimbursement combinations and monitor variance to protect ASP and reduce leakage.

AI and Automation Enablement and Vendor Partnership (as applicable)

  • Identify opportunities to move from manual, fragmented workflows to more predictive and prioritized execution, particularly in denials, prior authorization, and follow up work, using AI and workflow intelligence where appropriate.
  • Partner across functions to evaluate workflow, data integration, and compliance risks (data quality, explainability, adoption, and PHI and auditability) in any AI enabled approach.

People Leadership & Cross-Functional Influence

  • Lead and develop a high performing Strategy & Analytics team that includes analytics and reporting as well as program management capability (team structure may include manager and analyst roles).
  • Foster strong partnerships across key stakeholders to align strategy with execution and ensure accountability is clear across RCM and Market Access.
  • Model Baylor Genetics leadership behaviors and values, emphasizing clear communication and alignment, fact and data driven decisions, and fiscal responsibility.

Qualifications and Experience

Education

  • Bachelor’s degree in a business, finance, data, or related discipline; MBA or equivalent experience preferred.

Experience

  • 8+ years of experience in strategy, operations, analytics, consulting, or revenue cycle and reimbursement leadership, including at least 2 to 3 years leading teams.
  • Demonstrated ability to build operating rhythms, dashboards, and executive reporting that drive measurable outcomes.
  • Proven ability to structure ambiguous problems, align cross-functional stakeholders, and deliver results in complex environments.

Required

  • Deep comfort with reimbursement and claims analytics, including working with payer performance trends and KR and KPI governance.
  • Familiarity with governance needs tied to payer mapping and mapping at the CPT level and authorization level.

Preferred

  • Experience in precision diagnostics/molecular diagnostics reimbursement environments.

Skills and Competencies

  • Executive ready communication: ability to translate complex data into clear insights and action.
  • Strong analytical and financial acumen; ability to define metrics and run performance management forums.
  • Influence and collaborate across functions; ability to drive alignment and accountability across teams.
  • Fact and data driven, action oriented leadership; clear communication and alignment.

Physical Demands and Work Environment

Frequently required to sit. Frequently required to stand. Frequently required to utilize hand and finger dexterity. Frequently required to talk or hear. Frequently required to utilize visual acuity to operate equipment, read technical information, and/or use a keyboard.

EEO Statement

Baylor Genetics is an equal opportunity employer dedicated to building an inclusive and diverse workforce. We do not discriminate based on race, religion, color, national origin, sex, sexual orientation, age, gender identity, veteran status, disability, genetic information, pregnancy, childbirth, or related medical conditions, or any other status protected under applicable federal, state, or local law.

 

Note to Recruiters:

 We value building direct relationships with our candidates and prefer to manage our hiring process internally. While we occasionally partner with select recruitment agencies for specialized roles, we do not accept unsolicited resumes from recruiters or agencies without a written agreement executed by the authorized signatory for Baylor Genetics ("Agreement"). Any resumes submitted to Baylor Genetics in the absence of an Agreement executed by Baylor Genetics' authorized signatory, will be considered the property of Baylor Genetics, and Baylor Genetics will not be obligated to pay any associated recruitment fees.


Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Top Skills

Ai Enablement
Data Analytics
Executive Reporting
Kpi Governance
Program Management
Reimbursement Analytics
Workflow Intelligence
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The Company
HQ: Houston, TX
202 Employees
Year Founded: 1978

What We Do

Baylor Genetics is a joint venture of H.U. Group Holdings, Inc. and Baylor College of Medicine, including the #1 NIH-funded Department of Molecular and Human Genetics. Located in Houston’s Texas Medical Center, Baylor Genetics serves clients in 50 states and 16 countries.

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