SVP, Client Delivery & Operations
The most important hire we will make this year. You own delivery, the P&L behind it, and the one outcome that decides whether this business compounds or leaks: clients do not leave.
The role
What this job actually is
Mastery of the RCM metric set is mandatory: net collection rate, gross collection rate, days in AR, AR over 90 days, denial rate, first-pass resolution rate, clean claim rate, cost to collect, charge lag and DNFB. You must be able to read them, explain what moves them, and act on them.
This is the operational apex of the company and the seat every service line reports into. You own client delivery end to end, the P&L that sits under it, and the performance of every operational leader below you. The mandate is blunt: our clients stay, our numbers improve quarter over quarter, and our leaders get measurably better because you coached them. We work substantially in contingent models, which means our revenue is our clients' collections. There is no invoice to hide behind and no way to be profitable while the client underperforms. That alignment is the whole thesis of this firm, and this seat is where it is either honoured or lost. Compensation is set to be best in industry for this role, because the seat is worth it and because we intend to win the person, not negotiate them down.
Ownership
What you will own
Client retention, above everything else
You own logo retention and net revenue retention. Every account carries a named health status you can defend with evidence, every at-risk account has a written recovery plan with an owner and a date, and no client ever churns as a surprise. A client lost quietly is the single most expensive failure in this business, and preventing it is the first line of your job description.
The delivery P&L
Own revenue, cost to serve, gross margin and utilisation across the delivery organisation. Price-to-cost discipline, headcount and span-of-control decisions, automation payback, and the honest call on which accounts are structurally unprofitable and what we do about them.
Every operational outcome we publish
Net collection rate, days in AR, AR over 90, denial rate, first-pass resolution, clean claim rate, cost to collect, charge lag and DNFB, across every client and every service line. You do not merely report these. You move them, and you can explain in one sentence what is driving each one.
Coaching, monitoring and measuring your leaders
Directors of Coding, RCM Operations and ABA report to you, and the team leads under them. Run a real performance system: scorecards that mean something, a weekly operating rhythm, monthly one-to-ones with documented development plans, and honest calibration. Build the bench so no client and no service line depends on a single person.
Contingent-model economics
In a contingency engagement, throughput and quality are revenue. Own the levers: staffing against inventory, productivity standards that hold quality constant, recovery on aged AR, and the front-end fixes that stop rework before it is created.
The client relationship at the executive level
Be the operational face to hospital CFOs, large physician group executives and practice owners. Run QBRs that a CFO respects, own escalations personally, and be the person a client calls before they call a competitor.
Delivery capability and scale
Onboarding that starts clean, SOPs that are current, cross-training that removes single points of failure, and an automation agenda executed with our technology team so capacity grows faster than headcount.
Ramp
Your first 90 days
First 30 days
Get to ground truth. Every client, every contract, every margin, every metric, every leader. Come back to the CEO with an unvarnished read: which accounts are genuinely at risk, where the delivery P&L actually leaks, and which leaders are performing, which are coachable, and which are not.
By day 60
Publish the operating system: the account health model, the retention playbook with named owners, the leader scorecard and cadence, the P&L view by client, and the ninety-day fix list ranked by dollars at stake.
By day 90
It is running, not planned. The weekly rhythm is live, every at-risk account has an executed recovery plan, at least two structural margin or quality problems are fixed with measured proof, and every leader below you knows exactly how they are measured.
Requirements
What we look for
- MANDATORY: working command of RCM metrics, net collection rate, days in AR, AR over 90, denial rate, first-pass resolution rate, clean claim rate and cost to collect
- MANDATORY: 20 or more years in end-to-end US healthcare revenue cycle, with escalating operational leadership responsibility
- MANDATORY: direct P&L ownership at scale. Revenue, cost to serve and margin, not a cost centre or a headcount budget
- MANDATORY: proven experience running contingent and contingency-fee engagement models, where the firm is paid on client collections
- MANDATORY: direct client ownership experience with hospitals and large physician groups, at the CFO and executive level, not through an intermediary or a US-based account team
- A demonstrable retention record. You can name accounts you saved, what was actually wrong, and what you changed
- Has built and led multi-layer leadership structures: directors, managers and team leads, with a real performance and development system behind it
- Fluent across the full revenue cycle: eligibility and authorization, coding and documentation, charge capture, claims and edits, AR and denials, credentialing and enrolment, and patient collections
- Able to sit in front of a hospital CFO and hold a numbers conversation with total credibility
- On-site in Chennai, with the schedule flexibility that US client leadership requires
Bonus
Strong plus, not required
- Experience across behavioral health and ABA, hospital and facility, FQHC, ASC or multi-specialty physician groups
- Has carried an offshore delivery organisation serving US providers at 300+ FTE scale
- Track record deploying automation or AI into live delivery and proving the cost-to-collect impact
- Experience integrating an acquired book of business or a transitioned client base without service disruption
- Exposure to SOC 2, HITRUST or ISO 27001 operating discipline
Accountability
How this role is measured
| Measure | What it means |
|---|---|
| Client retention | Logo retention and net revenue retention. The number this seat is judged on first. |
| Delivery gross margin | Margin by client and in total, against plan. |
| Net collection rate | Portfolio-wide, trending up, with no client left behind the average. |
| Days in AR and AR over 90 | Down and holding across the book, not just in the best accounts. |
| Denial rate and first-pass resolution | Improving through prevention, not just recovery. |
| Cost to collect | Falling as automation and productivity compound. |
| Leader performance | Scorecard attainment of the leaders reporting to you, and their bench depth. |
| Escalation health | Volume, age and repeat rate of client escalations, all trending down. |
Why ASP-RCM
Why this seat is different
We are senior-led by design. A senior partner is named on accounts and shows up in the work, which is why clients renew and why this role carries real authority rather than a title. Our AI suite is in production, not in a roadmap deck, and our compliance posture is independently audited: SOC 2 Type II with HITRUST, ISO 27001 and HIPAA.
We pay for certifications and run upskilling cohorts, because coding and revenue cycle are crafts that need investment. You will work across Dallas HQ, six US states and Chennai, India, with colleagues who have run these functions at scale.