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Director, Denials AI

Med-Metrix
Posted a day ago, valid for 18 days
Location

Parsippany-Troy Hills, NJ, US

Salary

Competitive

Contract type

Full Time

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Sonic Summary

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  • The Director, Denials AI is responsible for leading the implementation and optimization of the Denials AI platform, ensuring it meets client needs and evolves effectively.
  • Candidates must have a Bachelor's degree in a relevant field and at least 7 years of experience in healthcare technology or software implementations, along with 3 years of team management experience.
  • The role involves overseeing solution design, workflow configuration, and client support, while also establishing performance metrics and driving continuous improvement initiatives.
  • Strong SQL skills and knowledge of healthcare data transactions are required, along with the ability to communicate complex concepts effectively to various stakeholders.
  • The salary for this position is competitive and commensurate with experience, reflecting the seniority of the role in the organization.

Job Purpose

The Director, Denials AI is responsible for leading the successful implementation, adoption, optimization, and ongoing support of the Denials AI platform. The Director, Denials AI serves as the primary bridge between Product, Analytics, Data, Operations, Client Delivery, and Support teams to ensure that the platform continues to evolve while delivering measurable client outcomes.

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Duties & Responsibilities

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  • Serve as the business owner and primary advocate for the Denials AI Workflow platform
  • Lead implementation efforts for new Denials AI clients and existing client expansions
  • Oversee solution design, workflow configuration, testing, training, go-live, and stabilization activities
  • Ensure successful integration of client data, workflows, and operational processes into the platform
  • Drive implementation best practices, standards, templates, and governance
  • Identify implementation risks and proactively develop mitigation strategies
  • Establish scalable implementation methodologies to support continued growth
  • Partner with Product, Operations, and Engineering teams to define product vision, priorities, and roadmap
  • Gather feedback from implementations, operations teams, and clients to identify enhancement opportunities
  • Build, mentor, and lead a team of implementation consultants and solution analysts
  • Create a culture of accountability, innovation, ownership, and continuous learning
  • Establish performance metrics, implementation of KPIs, support SLAs, and operational dashboards
  • Drive continuous improvement initiatives across onboarding, support, and product adoption processes
  • Develop team capabilities in technical troubleshooting, workflow optimization, and client consulting
  • Act as the primary escalation point for complex implementation and support issues
  • Facilitate alignment between business requirements and technical execution
  • Ensure stakeholder transparency through executive reporting and regular status communications
  • Oversee post-go-live client support and transition to steady-state operations
  • Partner with support and development teams to resolve high-priority client concerns
  • Other duties as assigned
  • Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  • Understand and comply with Information Security and HIPAA policies and procedures at all times
  • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

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Qualifications

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  • Bachelor's degree in Computer Science, Information Systems, Healthcare Administration, Engineering, Data Analytics, or related field
  • 7+ years of experience in healthcare technology, software implementations, product management, or technical operations
  • 3+ years of experience leading and managing teams
  • 3+ years leading implementation, support, consulting, or product-focused teams
  • Experience as a Product Owner, Solution Owner, Technical Lead, or Implementation Leader
  • Proven experience managing complex software implementations
  • Comfortable presenting to executives, clients, and technical teams with the ability to communicate complex concepts clearly and effectively
  • Strong SQL skills with the ability to write complex queries, analyze datasets to validate implementation results
  • Knowledge of healthcare data transactions
  • Knowledge of AWS Cloud technologies, AI/ ML-enabled healthcare applications preferred
  • Proficiency in Microsoft Office Suite
  • Strong interpersonal skills, ability to communicate well at all levels of the organization
  • Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
  • High level of integrity and dependability with a strong sense of urgency and results orientedĀ 
  • Excellent written and verbal communication skills required

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Working Conditions

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  • Willingness to work a flexible schedule and outside of normal business hours as needed
  • Occasional travel to client sites may be required
  • Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes
  • Physical Demands:Ā While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
  • Mental Demands:Ā The employee must be able to follow directions, collaborate with others, and handle stress
  • Work Environment:Ā The noise level in the work environment is usually minimal

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Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.




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