VP of Payer Contracting & Revenue Strategy

RevOps Careers; Boynton Beach (FL); Sur place; USD 180 000 - 260 000; Plein temps

Résumé du poste

RevOps Careers seeks a visionary VP, Managed Care & Payer Contracting to lead national payer strategy for behavioral health services. You will drive OON to INN transitions, negotiate with commercial payers, and build a scalable contracting function across multiple states.

The role requires 10+ years in managed care, a strong background in behavioral health contracts, and exceptional financial modeling. Location in South Florida with 30–40% travel offers high-impact leadership and growth

Qualifications

• 10+ years of managed care contracting experience, with 5+ years negotiating with commercial payers.
• Experience in behavioral health contracting across SUD and mental health.
• Proven success converting OON to INN or establishing network participation for multi-site provider.
• Multi-state payer contracting experience, including Medicaid MCO environments.
• Knowledge of reimbursement methodologies, utilization review, prior authorization, and mental health parity.
• Strong financial and contract modeling skills; ability to build and defend pro forma.
• Bachelor’s degree in Business, Finance, Healthcare Administration or related field; MBA/MHA/JD preferred.
• Established relationships with national and regional payers and behavioral health vendors preferred.

Responsabilités

• Develop and execute a national payer contracting strategy across multiple payers.
• Lead payer negotiations from strategy through execution, including rates and terms.
• Drive transition from OON to INN balancing access and reimbursement.
• Build financial models comparing OON vs INN, volume, and net revenue by level of care.
• Evaluate payer opportunities in new markets to support national expansion.
• Collaborate with Revenue Cycle, Operations, Clinical, Admissions, Marketing, and Legal to implement contracts.
• Monitor contract performance and payer relationships; report KPIs to leadership.
• Lead and develop contracting function and serve as primary payer network relationship owner.

Connaissances

Managed care contracting

Payer negotiations

Behavioral health contracting

OON to INN transitions

Financial modeling

Multi-state payer contracting

Reimbursement methodologies

Formation

Bachelor's degree in Business/Finance/Healthcare Administration

MBA/MHA/JD preferred

Description du poste

RevOps Careers seeks a visionary VP, Managed Care & Payer Contracting to lead national payer strategy for behavioral health services. You will drive OON to INN transitions, negotiate with commercial payers, and build a scalable contracting function across multiple states.

The role requires 10+ years in managed care, a strong background in behavioral health contracts, and exceptional financial modeling. Location in South Florida with 30–40% travel offers high-impact leadership and growth