VP, Revenue Cycle Strategy & Operations

Xtensys has exclusively retained Kirby Partners to support its search for a VP, Revenue Cycle Strategy and Operations.

Headquartered in Ithaca, New York, and expanding nationwide, Xtensys is a rapidly growing managed service provider with 450 employees. The organization serves hospitals, health systems, provider groups, community hospitals, critical access facilities, and expanding health systems.

Xtensys delivers healthcare revenue cycle services and technology-enabled solutions, along with IT, cybersecurity, infrastructure, and EHR services designed to help healthcare organizations strengthen operations and navigate an evolving healthcare landscape. Backed by two forward-thinking healthcare organizations, Xtensys is deeply committed to advancing rural and community care through technology, partnership, and innovation.

The company operates in a high-growth, performance-driven environment with a strong focus on client outcomes, scalability, and margin discipline. Its culture is built on collaboration, accountability, curiosity, and a shared passion for making healthcare better.

Xtensys embraces a remote-first culture built on trust, collaboration, and flexibility, while recognizing the value of coming together throughout the year for key moments that strengthen connection, innovation, and teamwork.

Position Overview

The Vice President of Revenue Cycle Strategy and Operations provides executive leadership for Xtensys’ vendor-delivered portfolio of mid- and back-end revenue cycle services.

Reporting to the CEO, this leader is responsible for service delivery, client outcomes, operating performance, and growth support across a diverse client portfolio. The role requires the credibility of a health system revenue cycle operator, combined with the commercial discipline, client orientation, and scalability mindset required in a vendor services environment.

This is a strong opportunity for a revenue cycle leader who wants to apply deep operational expertise in a broader client-facing role, helping Xtensys deliver financial outcomes for clients while aligning services, technology, and delivery models with real-world revenue cycle needs.

This role is focused on mid- and back-end revenue cycle services, including coding, clinical documentation improvement, charge capture and CDM optimization, billing, claims management, accounts receivable management, denials prevention and recovery, payer underpayment recovery, revenue integrity, and compliance support.  While front-end revenue cycle functions are out of scope (including patient access, registration, scheduling, front-end operations, and HIM record management), this role will require establishing strong, collaborative relationships with customer leaders for service delivery and thought leadership.

Work Location

This is a remote position, with travel expected approximately quarterly for team meetings, client engagements, and other business needs.

Key Responsibilities

Client Delivery and Operating Performance

• Provide executive oversight for vendor-delivered revenue cycle services across multiple client engagements.
• Own client financial outcomes, service quality, service-level agreements, and performance guarantees where applicable.
• Establish standardized delivery models, operating playbooks, workflows, and governance structures that scale across clients.
• Serve as executive sponsor for strategic client relationships, escalations, steering committees, and governance forums.
• Partner with finance to manage margins, utilization, cost structure, and profitability of service offerings.

Financial Outcomes, Payer Strategy, and Compliance

• Drive measurable client results, including cash acceleration, net revenue lift, AR days reduction, denial reduction, recovery yield, and clean claim rate improvement.
• Translate operational improvement into clear ROI and value realization for clients and internal stakeholders.
• Provide strategic oversight for denials root cause analysis, prevention strategies, clinical and technical appeal workflows, underpayment identification, and payer recovery.
• Monitor payer behavior, reimbursement trends, and regulatory changes to adjust service strategies as needed.
• Partner with clinical, compliance, and legal stakeholders to support defensible, compliant revenue optimization.
• Identify and mitigate operational and compliance risks that could affect client outcomes or vendor performance.

Commercial, Consulting, and Product Partnership

• Support sales and account teams in executive-level client discussions, solution design, pricing, RFP responses, due diligence, and expansion opportunities.
• Help shape service offerings based on market demand, payer behavior, client feedback, and operational insight.
• Lead or oversee revenue cycle assessments, performance diagnostics, and transformation initiatives.
• Translate complex operational challenges into clear executive narratives, recommendations, and action plans.
• Act as a trusted advisor to client CFOs and other executive leaders while balancing client-specific needs with scalable service models.
• Partner with product and technology teams to validate automation, analytics, AI-enabled solutions, and workflow improvements against real-world revenue cycle needs.

Leadership and Team Development

• Build and lead high-performing, geographically distributed, client-facing delivery teams.
• Develop leaders who can operate effectively in client-facing, matrixed environments.
• Establish a culture of accountability, transparency, performance, and continuous improvement.

Success in This Role

Success will be measured by the VP’s ability to deliver measurable client financial outcomes, maintain strong service performance across engagements, improve margin and scalability, support client retention and expansion, and translate operational insight into better service, product, and technology solutions.

Qualifications

Required Qualifications

• Bachelor’s degree required.
• 12+ years of progressive mid- and back-end healthcare revenue cycle experience, including leadership experience in a vendor, consulting, managed services, outsourcing, or comparable client-facing delivery environment.
• Demonstrated success owning client outcomes, financial performance, and service delivery in a vendor or client-facing services environment.
• Deep expertise in coding, CDI, billing, AR operations, denials management, payer recovery, revenue integrity, reimbursement, and compliance risk.
• Strong understanding of Medicare, Medicaid, and commercial reimbursement.
• Experience working with major EHR platforms; Epic experience required.
• Proven ability to engage credibly with health system CFOs and senior executive leaders.
• Strong financial and analytical acumen, with the communication and client management skills needed to operate in a senior client-facing role.

Preferred Qualifications

• Master’s degree.
• Experience in a PE-backed or high-growth services organization.
• Familiarity with performance-based or at-risk service models.
• Comfort operating with EBITDA, margin, utilization, and profitability targets.

Procedure for Candidacy

Final candidates should expect two interviews with Kirby Partners recruiters (including a video conference interview). You may be asked to complete our “Executive Profile” and submit references to be considered for presentation to the search committee.