Insurance Head

• We are looking for a Head of Hospital Insurance to lead the strategic, operational, and financial management of insurance functions within a hospital or healthcare system.
• In this position, you will lead teams responsible for insurance authorization, eligibility verification, claims coordination, appeals, contract analysis, and payer issue resolution.
• You will establish performance metrics, implement process improvements, and drive accountability across the insurance lifecycle.

Role & responsibilities

• Develop and lead the hospitals insurance strategy across payer operations and reimbursement performance
• Oversee payer contracting, renewals, negotiations, and contract compliance monitoring
• Direct insurance verification, prior authorization, claims coordination, and denial management functions
• Analyze reimbursement trends and identify opportunities to improve net revenue and reduce leakage
• Collaborate with finance, revenue cycle, legal, and clinical leaders on payer-related initiatives
• Monitor regulatory and payer policy changes affecting hospital billing and coverage requirements
• Establish KPIs, dashboards, and reporting standards for insurance operations and payer performance
• Lead escalation and resolution of complex payer disputes, underpayments, and appeals
• Ensure staff training and process consistency across insurance workflows and documentation standards
• Support executive decision-making with data-driven recommendations on payer mix and contract strategy

Preferred candidate profile

• Extensive experience in hospital insurance operations, managed care, or revenue cycle leadership
• Strong knowledge of commercial insurance, Medicare, Medicaid, and hospital reimbursement models
• Proven success in payer negotiations, denial reduction, and reimbursement optimization
• Experience leading cross-functional teams in complex healthcare environments
• Excellent analytical, communication, and stakeholder management skills
• Deep understanding of healthcare compliance, billing regulations, and payer policy interpretation
• Ability to use data to identify trends, risks, and operational improvement opportunities