Vice President of Revenue Operations (Boynton Beach)
RevOps Careers
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
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