About This Role
We are seeking a Payer and Managed Care Subject Matter Expert (SME) to support a strategic engagement focused on assessing managed care readiness and growth opportunities for a leading nonprofit behavioral health provider. This SME will bring deep expertise in managed care contracting, reimbursement economics, and payer strategy for behavioral health services, shaping practical recommendations for executive decision-making and operational design.
This engagement is fractional, contributing to Phase 1 strategy design, proposal development, managed care assessment, and advisory support during key leadership discussions.
What You Will Work On
- Evaluate feasibility of payer diversification across commercial, Medicare, Medicare Advantage, Medi-Cal managed care, and managed behavioral health organizations.
- Provide insight into credentialing, utilization management, contracting, and network participation processes for behavioral health.
- Analyze and model reimbursement economics, including rate scenarios, administrative burden, and margin implications.
- Recommend go-to-market approaches (incremental contracting, payer partnerships, distinct product lines, or spin-outs).
- Prepare leadership for payer negotiations and compliance with managed care requirements.
What You Will Bring
- 10+ years of senior leadership experience in managed care, payer contracting, or revenue cycle strategy, ideally within behavioral health.
- Direct experience negotiating managed behavioral health contracts, including IPA/network development and credentialing requirements.
- Proven ability to model reimbursement scenarios and financial viability for payer-facing services.
- Familiarity with payer reporting, utilization review, CMS compliance, and quality metrics for behavioral health.
- Strong executive presence and ability to translate technical managed care concepts into clear strategic options.
What You Can Expect
- An inspirational place for you to do your best work, be engaged in meaningful ways, and continually develop the skills, competencies and qualities that set our team apart.
- Compensation commensurate with your qualifications, experience, and other factors including geographic location, market and operational factors.
- Total Rewards include: Medical, Dental, Vision, Life Insurance, Disability Insurance, 401(k) Savings Plan, Employee Stock Purchase Plan, Professional Development Program, Paid Time Off and Paid Sick Time (in geographies where legally required).
What We Do
At RGP, we're creating a future where businesses produce their best work without constraints. We've built a global network of over 2,600 experts across four regions, providing a comprehensive suite of solutions across on-demand talent, next-generation consulting, and outsourced services to support organizations at every stage of their growth journey. Trusted by Fortune 100 companies and emerging disruptors alike, we challenge conventional ways of working, drive growth, and pave the way for long-term success through bold innovation and fearless collaboration.
Our values guide everything we do and strengthen our commitment to people. By combining smart processes, human-centered design, and advanced technology, we celebrate our team's excellence and ensure we grow together. We believe in the power of continuous learning and development to drive both individual and organizational success. It’s time to rethink how work gets done. Dare to Work Differently® with RGP.
RGP is proud to be an Equal Opportunity Employer and committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, national origin, gender, pregnancy, sexual orientation, gender identity, age, physical or mental disability, genetic information, veteran status, or any other legally protected trait and encourage all applicants to apply.
