VP, Insurance Clearinghouse Services

Vice President of Clearinghouse Services is responsible for defining and executing the strategic vision for FinThrive's clearinghouse operations, ensuring seamless transaction processing, payer connectivity, and vendor management across a global team. This role has a direct impact on operational efficiency, cost optimization, and customer satisfaction by expanding direct payer connections, negotiating favorable contracts, and driving technology innovation. As a key leader, the VP supports FinThrive's corporate initiative to strengthen clearinghouse capabilities and reduce reliance on intermediaries, enabling the organization to deliver differentiated value, maintain compliance, and position itself as a leader in healthcare connectivity.

What you will do

Major Responsibilities/Activities:

• Drive the strategic vision and business plan for FinThrive's clearinghouse services, ensuring alignment with corporate objectives and customer needs.
• Lead global clearinghouse operations across production, payer support, insurance clearinghouse (ICH) support, and payer relations, delivering reliable and scalable transaction processing.
• Establish and expand direct payer connections and trading partner relationships to enhance network reach and reduce dependency on intermediaries.
• Negotiate contracts and volume-based pricing with payers and vendors to optimize cost structures and improve financial performance.
• Manage trading partner traffic to optimize volumes, revenue and cost
• Ensure compliance with HIPAA, CMS, and other regulatory requirements, maintaining audit readiness and implementing risk mitigation strategies.
• Monitor transaction volumes, payer rates, and vendor costs, using KPIs to drive operational efficiency and continuous improvement.
• Oversee technology modernization initiatives, including EDI/API connectivity, automation, and digital transformation to improve clearinghouse capabilities and efficiency.
• Represent FinThrive at healthcare industry events and association meetings to deepen payer relationships and develop new opportunities
• Develop and mentor a high-performing global team of professionals, fostering a culture of accountability, innovation, and customer-centricity.

What you will bring

• Minimum 10 years of leadership experience in healthcare revenue cycle management (RCM), clearinghouse operations, or payer connectivity.
• Deep understanding of EDI/API transactions, payer connectivity, and clearinghouse technology platforms.
• Strong knowledge of HIPAA, CMS, HL7 and other regulatory requirements for healthcare data exchange.
• Demonstrated ability to negotiate contracts, manage vendor relationships, and optimize cost structures.
• Ability to develop and mentor global teams, foster innovation, and drive cultural transformation.
• Strong financial acumen with ability to forecast transaction volumes and monitor KPIs for operational efficiency.
• Up to 25% (travel could reach 1 out of every 4 weeks)

What we would like to see

• Track record of innovation in clearinghouse operations and customer experience improvement.
• Familiarity with payer contracting strategies and advanced reimbursement models.
• Experience working with large-scale clearinghouse platforms or healthcare technology companies.
• Proven success in building direct payer networks and reducing reliance on intermediaries.
• Strong executive presence and ability to influence at the C-suite level.
• Experience leading global teams and driving cultural transformation across regions.
• Exposure to data analytics tools for monitoring transaction performance and cost optimization.
• Background in API-based connectivity, automation, and digital transformation initiatives.
• Familiarity with print shop operations and transaction workflows.
• Bachelor's degree or equivalent experience; Business, Healthcare Administration, or related field preferred.