Director Denial Management and Prevention (RN)

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director Denial Management and Prevention (RN) based in United States.

This leadership role oversees denial prevention, recovery, and appeals operations across a multi-hospital healthcare system. The position combines clinical expertise, revenue cycle knowledge, analytics, and strategic leadership to reduce denials and improve reimbursement outcomes.

You will partner with senior clinical and operational leaders to identify mitigation opportunities and implement sustainable improvements across hospital entities. The role provides strategic direction and clinical oversight for denial and appeal activities while using performance data and industry benchmarks to drive results.

You will also collaborate with case management, managed care, compliance, reimbursement, and external business partners to address payer and regulatory challenges. A key focus will be developing standardized analytics, strengthening operational processes, and optimizing technology to improve efficiency.

This is a fully remote, full-time leadership opportunity for an experienced RN with strong revenue cycle and denial management expertise.