Vice President of Revenue Operations

Vice President, Managed Care & Payer Contracting

Location: South Florida preferred | Approximately 30–40% travel

• Competitive salary plus an annual bonus

A rapidly growing, multi-state behavioral health organization is seeking an experienced Vice President of Managed Care & Payer Contracting to lead its national payer contracting strategy.

This is a high-impact leadership opportunity for a managed care executive who has successfully navigated out-of-network (OON) to in-network (INN) transitions and understands the complexities of behavioral health reimbursement, payer negotiations, and multi-state expansion.

The VP will develop and execute payer strategy across SUD, mental health, and high-acuity psychiatric services spanning inpatient, residential, PHP, IOP, and outpatient levels of care.

Key Responsibilities

• Develop and execute a national, state-by-state payer contracting strategy , prioritizing commercial, Medicaid MCO, Medicare Advantage, ACA, TRICARE/VA, and other key payer opportunities.

• Lead payer negotiations from strategy through execution , including rates, reimbursement methodology, authorization/UR terms, level-of-care coverage, escalators, and contract provisions.

• Drive the organization’s strategic transition from OON to INN , balancing increased network access and patient volume with strong reimbursement and margin protection.

• Build financial models comparing OON collections, proposed INN rates, anticipated volume, length of stay, and net revenue by level of care.

• Evaluate payer opportunities in new markets to support continued national expansion and de novo growth.

• Partner closely with Revenue Cycle, Operations, Clinical, Admissions, Marketing, and Legal to ensure successful contract implementation.

• Monitor contract performance, payment accuracy, underpayments, renewals, and payer relationships while reporting key performance metrics to executive leadership.

• Lead and develop the existing contracting function and serve as a primary relationship owner with payer network and behavioral health leadership.

Qualifications

• 10+ years of managed care contracting experience , including 5+ years directly leading negotiations with commercial payers.

• Significant behavioral health contracting experience , ideally across SUD and mental health services.

• Proven success converting a healthcare organization from OON to INN or establishing network participation for a growing multi-site provider.

• Multi-state payer contracting experience, including familiarity with Medicaid MCO environments.

• Strong knowledge of reimbursement methodologies, utilization review, prior authorization, and mental health parity requirements.

• Strong financial and contract modeling skills with the ability to build and defend payer contract pro formas.

• Bachelor’s degree in Business, Finance, Healthcare Administration, or a related field required; MBA, MHA, or JD preferred .

• Established relationships with national and regional payers and behavioral health vendors are highly preferred.

The Opportunity

This is a builder role, not a maintenance role . The VP will have the opportunity to shape the payer strategy for a growing national behavioral health platform, influence expansion into new markets, and build a contracting infrastructure capable of supporting significant long-term growth.

Tagged as: Financial Modeling