Senior Vice President of Eligibility, Claims and Revenue Management

Senior Vice President Of Eligibility, Claims And Revenue Management

We are seeking a strategic and operationally strong Senior Vice President of Eligibility, Claims and Revenue Management to lead and optimize our eligibility and claims functions as well as revenue cycle management. This executive role is critical to ensuring the accuracy, efficiency, and scalability of our core operational processes that directly impact revenue recognition, customer satisfaction, and compliance.

The ideal candidate will bring deep healthcare operations experience, strong technical acumen, and a collaborative leadership style to drive continuous improvement across eligibility data management and outsourced claims processing. This role reports directly to the Chief Operating Officer (COO) and is responsible for leading a team across claims management, eligibility, carrier and member revenue operations, billing, and cash conversion functions. The ideal candidate is a strategic thinker and hands-on leader with a proven ability to drive operational excellence, optimize performance, and foster a high-performing team culture.

What you'll do

• Lead, mentor, and develop a team of 40+ individuals across multiple functions.
• Establish clear goals, accountability structures, and professional development pathways.
• Promote a culture of collaboration, ownership, and continuous improvement.
• Lead the end-to-end eligibility function, including data validation, exception resolution, and reporting.
• Ensure accurate onboarding and billing of customers, carriers, and members through robust eligibility processes.
• Partner with Client Success and Implementation teams to ensure receipt and integration of standard eligibility file formats.
• Manage exceptions where custom file formats are required, with a long-term strategy to migrate to standard formats.
• Develop and maintain dashboards and KPIs to monitor eligibility data quality and operational performance.

Claims Management :

Revenue Cycle Management :

Cross-Functional Leadership :

About you

Please note : This is not a digital nomad or remote international position; candidates must be based in the United States. Progyny is unable to provide visa sponsorship for this position. Candidates must be authorized to work in United States without the need for sponsorship, now or in the future.

About Progyny :

Progyny is a global leader in women's health and family building solutions, trusted by the nation's leading employers, health plans and benefit purchasers. We envision a world where everyone can realize dreams of family and ideal health. Our outcomes prove that comprehensive, inclusive and intentionally designed solutions simultaneously benefit employers, patients and physicians.

Our benefits solution empowers patients with concierge support, coaching, education, and digital tools; provides access to a premier network of fertility and women's health specialists who use the latest science and technologies; drives optimal clinical outcomes; and reduces healthcare costs.

Our mission is to empower healthier, supported journeys through transformative fertility, family building and women's health benefits.

Headquartered in New York City, Progyny has been recognized for its leadership and growth as a TIME100 Most Influential Company, CNBC Disruptor 50, Modern Healthcare's Best Places to Work in Healthcare, Forbes' Best Employers, Financial Times Fastest Growing Companies, Inc. 5000, Inc. Power Partners, and Crain's Fast 50 for NYC. For more information, visit www.progyny.com.

Our perks :

In compliance with New York City's Wage Transparency Law, the annual salary range for NYC-based applicants is $280,000 - $300,000. There are a variety of factors that go into determining a salary range, including but not limited to external market benchmark data, geographic location, and years of experience sought / required. Progyny offers a total compensation package comprised of base salary, cash bonus, and equity.

Progyny is proud to be an Equal Opportunity and Affirmative Action employer. We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences within our workforce. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, age, genetic information, marital status, pregnancy or related condition, status as a protected veteran, criminal history consistent with legal requirements or any other basis protected by law.

If you are an individual with a disability and need assistance or an accommodation during the recruiting process, please send an e-mail to apply@progyny.com.