Managing Director - Independent Dispute Resolution (IDR) Services

Why this role matters You're a builder who thrives at the intersection of healthcare operations, regulation, and technology. Advantify is launching a high-impact IDR service line to help hospitals and providers win fair reimbursement under the No Surprises Act—reducing administrative pain, shortening cycle times, and improving dispute outcomes in a process that's notoriously complex and deadline-driven.

As Managing Director, you'll own the operationalization and scaling of this service from the ground up. You'll turn real-world IDR friction into elegant, automated workflows, partner closely with engineering to build differentiated tech, and help shape a go-to-market strategy that positions us as the go-to partner for providers navigating federal disputes. This is a rare chance to define a new category in healthtech while directly improving revenue outcomes for healthcare organizations.

What you'll do: Design & Lead the IDR Service Operation
• Own end-to-end federal IDR workflows—from eligibility screening and open negotiation through batching, submission, evidence organization, arbiter support, payment tracking, and robust reporting.
• Build scalable SOPs, controls, and compliance guardrails that keep us audit-ready while enabling rapid growth.
• Define and track the KPIs, SLAs, and operational metrics that drive service excellence and client success.

Collaborate Operations with Automation Team
• Map current- and future-state processes across providers, hospitals, and the federal IDR ecosystem.
• Write crystal-clear business requirements, functional specs, data models, decision logic, and timelines that engineering can build against directly.
• Act as the primary bridge between domain experts (revenue cycle, compliance, providers) and technical teams—ensuring nothing gets lost in translation.

Deepen Market & Regulatory Mastery
• Build expert-level understanding of provider revenue cycle pain points, denial patterns, documentation gaps, and payor adjudication behaviors.
• Stay ahead of CMS guidance, batching rules, IDR portal changes, and evolving regulations—quickly assessing and incorporating impacts.
• Spot high-leverage opportunities to cut admin burden, boost submission quality, shorten resolution times, and lift win rates.

Drive Innovation & Differentiation
• Champion AI/ML-powered features: assisted evidence review, predictive outcome modeling, regulatory decision support, smart batching, and analytics that give clients an edge.
• Support the product roadmap for scalable data platforms, workflow automation, and outcome optimization tools.

Support Growth & Client Success
• Collaborate with leadership on service packaging, pricing, positioning, and early go-to-market tactics.
• Engage in customer pilots, onboarding, feedback cycles, and sales enablement—bringing operational credibility to every conversation.

What we're looking for :

Required
• 5–8+ years in healthcare operations, revenue cycle management, payor/provider relations, regulatory/compliance programs, healthcare consulting, or healthtech-enabled services.
• Hands-on experience with the federal IDR process (post-2022 No Surprises Act).
• Proven track record turning complex, regulated processes into clear, actionable requirements that engineering teams successfully automate.
• Strong grasp of real-world provider and payor incentives, workflows, and constraints across multiple service lines and/or provider specialties.
• Cross-functional collaboration experience with product, engineering, or automation teams.
• Outstanding written communication—especially process maps, requirements docs, and business specifications.

Preferred (any of these strengthen your case)
• Leadership in revenue cycle, denials/appeals, or payor strategy inside provider organizations.
• Standing up new service lines, programs, or operational functions from scratch.
• Healthcare consulting focused on operations, revenue integrity, or managed services.
• Exposure to healthcare SaaS, managed services, or advisory models.

What we offer
• Fully remote, flexible work
• Competitive compensation + equity in a high-growth healthtech startup
• Opportunity to shape a category-defining service in a $multi-billion reimbursement challenge
• Direct impact on healthcare providers' financial health
• Collaborative team + strong executive sponsorship

If you're excited about building something meaningful at the nexus of regulation, operations, and technology—and you have the operational depth to make complex IDR processes fast, compliant, and winning—we'd love to hear from you.

Pay: $85,000.00 - $110,000.00 per year

Benefits:
• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off

Experience:
• Collection management: 2 years (Required)
• IDR and/or out-of-network billing: 2 years (Required)
• facility-based medical billing: 2 years (Required)
• Facility-Based revenue cycle management: 2 years (Required)

Work Location: Remote

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