Client Summary:

• Pediatric therapy organization providing specialized behavioral and developmental services across a large and growing network of care centers
• Delivers a comprehensive suite of therapy services to children with complex needs across both commercially insured and Medicaid populations
• Operates across multiple states with approximately 100 locations and a strong track record of clinical outcomes and family trust
• PE-backed organization in an active growth phase, expanding its footprint in response to increased demand and reimbursement opportunities for pediatric specialty services
• Positioned in a high-growth segment of healthcare services with a mission-driven focus on improving outcomes for children with developmental and behavioral health needs

Position Responsibilities:

• Serve as the senior executive interface with Medicaid and commercial payers across all service lines and states
• Own payer contracting strategy, reimbursement sustainability, and network positioning across all therapy service lines
• Lead payer strategy related to organizational and provider structure complexity including NPI reduction, TIN establishment, and contract alignment
• Lead payer discussions, contract amendments, and risk mitigation associated with NPI and TIN transitions to ensure revenue integrity and continuity of care
• Partner closely with Revenue Cycle and Credentialing leadership to align payer requirements, enrollment readiness, and go-live sequencing
• Anticipate and mitigate payer risks associated with structural changes including credentialing delays, authorization mismatches, and reimbursement disruption
• Serve as executive owner of payer readiness during structural or market transitions
• Advise the executive team on payer risk, state-level market viability, and decisions affecting center footprint and staffing
• Drive payer governance through scorecards, business reviews, and escalation of systemic payer risks

Experience & Skills:
Required Experience and Qualifications:

• 10+ years of experience in payer contracting, managed care, or network strategy within a multi-site healthcare services organization
• Deep expertise in Medicaid and commercial payer contracting across multiple states and service lines
• Proven experience managing complex provider structure transitions including NPI and TIN changes
• Strong understanding of credentialing, enrollment, and revenue cycle operations and how they intersect with payer strategy
• Experience serving as a senior payer-facing executive with demonstrated ability to negotiate and manage high-stakes payer relationships
• Track record of mitigating payer risk during periods of organizational growth or structural change

Preferred Experience and Qualifications:

• Experience in pediatric specialty, behavioral health, or ABA therapy environments
• Familiarity with Medicaid waiver programs and state-specific reimbursement structures
• Background working in PE-backed, multi-state healthcare services organizations
• Experience building payer governance infrastructure including scorecards and business review frameworks

Compensation $200k-$250k, Health Insurance, 401k, Paid Vacation