Vice President of Revenue Operations

Yoso Recruiting; Boynton Beach (FL); Sur place; USD 180 000 - 340 000; Plein temps

Résumé du poste

Yoso Recruiting seeks a Vice President of Managed Care & Payer Contracting to lead the national payer strategy for a rapidly growing behavioral health organization, based in South Florida with 30–40% travel.

You will drive OON to INN transitions, negotiate with commercial, Medicaid MCO, and Medicare Advantage payers, and build scalable contracting models across multiple states. Applicants should have 10+ years in managed care contracting and strong financial pro formas.

Qualifications

• 10+ years of managed care contracting experience, including 5+ years leading negotiations with commercial payers.
• Significant behavioral health contracting experience across SUD and mental health services.
• Proven success converting OON to INN or establishing network participation for a multi-site provider.
• Multi-state payer contracting experience, familiar with Medicaid MCO environments.
• Strong knowledge of reimbursement methodologies, utilization review, prior authorization, and parity requirements.
• Bachelor’s degree in Business/Finance/Healthcare Administration; MBA/MHA/JD preferred.

Responsabilités

• Develop a national payer contracting strategy across state lines, prioritizing key payer opportunities.
• Lead payer negotiations from strategy through execution, including rates and terms.
• Drive the organization’s OON to INN transition balancing access and reimbursement.
• Build financial models analyzing payor scenarios, volume, and net revenue by care level.
• Evaluate payer opportunities in new markets to support national expansion.
• Partner with Revenue Cycle, Operations, Clinical, Admissions, Marketing, and Legal.
• Monitor contract performance and payer relationships with executive-facing KPIs.
• Lead and develop the contracting function and primary payer relationships.

Connaissances

Payer contracting

Negotiation leadership

Financial modeling

Behavioral health contracts

Multi-state contracting

Formation

Bachelor's degree in Business/Finance/Healthcare Administration

MBA/MHA/JD preferred

Description du poste

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.