Director, Itemized Bill Review

Responsibilities

• Strategic Leadership & Business Ownership
• Own the strategic direction, growth, and performance of the Itemized Bill Review solution across all clients and lines of business.
• Accountable for achieving savings, revenue, and productivity targets for the solution.
• Develop and execute multi-year business plans that support organizational growth, client value, operational scalability, and product innovation.
• Establish, monitor, and report on key performance indicators (KPIs) and operational, financial, quality, and client performance metrics, utilizing data-driven insights to identify opportunities, mitigate risks, and drive achievement of strategic and operational goals.
• Partner with executive leadership to identify new savings opportunities, growth initiatives, and competitive differentiation strategies.
• Translate coding, reimbursement, regulatory, and market trends into strategic business recommendations and future-state product capabilities.
• Innovation, AI & Automation Leadership
• Lead the identification, prioritization, and implementation of AI, machine learning, and automation opportunities across the IBR solution.
• Partner with Product, Technology, and Analytics teams to modernize IBR workflows and improve scalability, productivity, coding accuracy, and savings capture.
• Drive the development of technology-enabled review methodologies that reduce manual effort while maintaining quality and compliance standards.
• Establish a multi-year innovation roadmap for the IBR solution aligned with enterprise automation and digital transformation objectives.
• Evaluate emerging technologies, coding intelligence tools, and reimbursement analytics capabilities to improve operational performance and client outcomes.
• Operational Leadership & Global Team Management
• Lead and develop a globally distributed team across the United States and India, ensuring operational consistency, workforce planning, talent development, and scalability.
• Establish performance management frameworks, quality standards, and operational governance processes that support business growth.
• Drive continuous improvement initiatives that improve productivity, savings outcomes, quality performance, and turnaround times.
• Foster a culture of innovation,

Benefits

Additional Information

At Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients. At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture. A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are. Position Overview The Director, Itemized Bill Review (IBR) is responsible for the strategic leadership, operational performance, innovation, and growth of the Itemized Bill Review solution across the Expert Claims Review business. This role serves as the enterprise leader for IBR, accountable for product performance, operational execution, quality outcomes, client value realization, and future-state solution development. The Director leads a globally distributed team across the United States and India, providing leadership for coding operations, quality programs, innovation initiatives, and operational excellence. This role partners closely with Product, Technology, Analytics, Operations, Sales, Client Management, and Implementation leadership to define and execute the long-term vision for IBR. As the senior business owner for the IBR solution, the Director is responsible for advancing automation, artificial intelligence, machine learning, workflow modernization, and new savings opportunities that improve scalability, coding accuracy, operational efficiency, and client outcomes. The role translates reimbursement trends, coding updates, market demands, and client needs into strategic initiatives that strengthen the IBR value proposition and support enterprise growth objectives.

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