Vice President of Payer Relations

Vice President of Payer Relations

About the Company

Mission-driven pediatric therapy provider serving children with complex behavioral and developmental needs.

Industry
Hospital & Health Care

Type
Privately Held, Private Equity-backed

About the Role

The Company is seeking a Vice President of Payer Relations to serve as the senior executive interface with Medicaid and commercial payers across all service lines and states. The successful candidate will be responsible for owning the payer contracting strategy, ensuring reimbursement sustainability, and leading network positioning efforts. This role requires a leader who can navigate the complexities of organizational and provider structure, including NPI reduction, TIN establishment, and contract alignment, and who can effectively manage payer discussions, contract amendments, and risk mitigation associated with these transitions. The VP will also be expected to partner closely with Revenue Cycle and Credentialing leadership, anticipate and mitigate payer risks, and serve as the executive owner of payer readiness during structural or market transitions. Applicants must have a minimum of 10 years' experience in payer contracting, managed care, or network strategy within a multi-site healthcare services organization, with a deep expertise in Medicaid and commercial payer contracting. A strong understanding of credentialing, enrollment, and revenue cycle operations is essential, as is a proven track record of managing complex provider structure transitions and mitigating payer risk. Preferred qualifications include experience in pediatric specialty, behavioral health, or ABA therapy environments, familiarity with Medicaid waiver programs, and a background in PE-backed, multi-state healthcare services organizations. The role demands a strategic thinker who can advise the executive team on payer risk, state-level market viability, and make decisions that impact the center footprint and staffing.

Functions

• Medical Care/Hospital Administration