The executive in charge of the hospital revenue cycle used to run what many health systems treated as a back-office function. In 2026, the job sits much closer to the center of health system strategy.
Payers are using AI to review claims, downcoding and denials are rising, and federal coverage changes are expected to increase uninsured and underinsured volumes. As a result, health system CEOs are taking a direct interest in how their organizations get paid. Revenue cycle leaders, in turn, are taking on broader responsibilities: building AI defenses, upskilling staff and planning for succession.
“No longer will we be an afterthought or an activity after a patient’s care journey, but rather a key strategic capability,” Amy Assenmacher, RN, senior vice president of revenue cycle at Grand Rapids, Mich.-based Corewell Health, said during a Becker’s CFO+Revenue Cycle Podcast episode.
Here are four things to know about the role in 2026:
1. Fewer systems are naming a chief, and most moves are at the vice president level. Becker’s executive move roundups through late September tracked two chief revenue officer appointments in 2026, down from nine at the same point in 2025. Chief revenue cycle officer appointments fell from five to one.
The work itself has not shrunk. Of 39 revenue cycle executive moves Becker’s reported this year, most were at the vice president, associate vice president or executive director level. Chief-titled hires included Bahar Bazmi as chief revenue cycle officer of Morgantown, W.Va.-based WVU Health System, David Summers as chief revenue officer of Oklahoma City-based Integris Health and Beth Carlson as chief revenue officer of Columbus-based Ohio State University Wexner Medical Center.
2. The titles are getting more specific. Many new revenue cycle leadership titles describe one part of the work instead of the whole cycle. Oakland, Calif.-based Kaiser Permanente named a senior vice president of revenue realization. St. Louis-based Ascension hired a vice president of national net revenue management. Nashville, Tenn.-based Vanderbilt Health added an associate vice president of revenue integrity and strategic pricing.
Other titles combine revenue cycle with finance or payer strategy. Lisa Maqueira was promoted to senior vice president of finance and chief revenue cycle officer at Los Angeles-based Cedars-Sinai, and Peoria, Ill.-based OSF HealthCare hired a senior vice president of strategic reimbursement and managed care.
3. The job now includes leading a health system’s response to payer automation. Several leaders told Becker’s in January that automation was their top 2026 priority, including Tony Morrison, vice president and chief revenue cycle officer at Sioux Falls, S.D.-based Sanford Health. Since then, leaders have warned that payers’ use of AI to review claims is moving faster than providers can respond, and that silent downcoding is cutting revenue that never shows up in denial reports.
“The greatest threat is not autonomous coding replacing staff,” Tami McMasters Gomez, executive director of mid-revenue cycle at Sacramento, Calif.-based UC Davis Health, told Becker’s. “It is payer automation denying or delaying reimbursement faster than providers can identify and respond to it.”
Some leaders doubt technology alone will settle the problem.
“We’ll put our bots in, they’ll put their bots in and the bots are fighting with the bots,” Marji Karlin, chief revenue officer of NYC Health + Hospitals, said at Becker’s 11th Annual Health IT + Digital Health + RCM Conference in September.
4. Building and keeping the team is a growing part of the job. Leaders have said their teams need new skills faster than they can train them. “The technical environment is changing faster than we can upskill our staff,” Ms. Karlin said. Aron Klein, senior vice president of finance operations at Urbana, Ill.-based Carle Health, said his back-office team of 350 employees always has about 30 open positions.
“I don’t think we’re going to have a need for less people,” he said. “I think those people are going to have to do more at the end of the day and leverage technology to the best of its ability.”
Succession planning is also a priority. Patrick McDermott, chief revenue officer at Danville, Pa.-based Geisinger, named “a strong, connected [revenue cycle] leadership team with a clear succession plan” as his top goal for 2026.
