Recently named one of North Texas' fastest-growing middle-market companies, Oceans Healthcare is a nationally recognized behavioral health provider focused on healing and long-term recovery. Founded in 2004, Oceans provides inpatient and outpatient treatment with a special focus on the unique physical and emotional needs of older adults and seniors. With 29 locations in Louisiana, Mississippi and Texas, Oceans is consistently recognized as a Top Performer on Key Quality Measures by The Joint Commission. 

Our company is passionate about helping older adults and seniors manage the challenges that come with aging and attain the best possible quality of life. We are committed to caring for this special population with dignity for patients and their families; with keen awareness of the importance of treating the whole person; with focus on progressive behavioral therapies; and with respect for our employees, physicians, healthcare providers and the communities we serve.

Industry: Hospitals and Health Care
Company Size: 1,001-5,000 employees

Oceans Healthcare

Savvy Admin PROD

At Oceans Healthcare, we are passionate about helping adults and seniors attain the best possible quality of life. As a nationally recognized provider of behavioral health services, we treat patients experiencing symptoms of depression, anxiety, schizophrenia, behavioral changes related to medication management or substance abuse and other behavioral issues.

Through our inpatient behavioral services and intensive outpatient programs, Oceans Healthcare offers comprehensive behavioral and mental health services to help patients at every stage of the healing process. Our staff is committed to caring for patients and their families with dignity, honesty and compassion.

The Vice President, Utilization Management serves as the executive leader responsible for enterprise strategy, performance optimization, and value-based resource management across Oceans Healthcare. This role establishes the organizational vision for utilization management, care progression, and reimbursement optimization and aligns clinical, operational, and financial stakeholders to support system growth, regulatory excellence, and sustainable margin performance.

The VP moves the organization beyond utilization review as a compliance function to a **strategic clinical and financial operating discipline **. The position partners with Vice President, Strategic Payer Relations & Performance, medical leadership, and revenue cycle leadership to improve payer performance, patient access, and reimbursement integrity while enhancing patient outcomes and physician engagement.

This executive will design and lead system-wide initiatives that integrate care coordination, documentation integrity, payer strategy, and operational workflows to ensure the organization delivers the right care, at the right level, at the right time, in the most appropriate setting.

**Essential Functions:**

- Establish the enterprise vision and long-term strategy for utilization management.

- Serve as the executive subject matter expert advising the CEO, COO, CFO, CMO, and Revenue Cycle leadership on utilization management payer trends and regulatory risk

- Provide executive utilization management reporting and performance analytics to leadership and the Board.

- Translate organizational growth goals into operational utilization management initiatives.

- Align hospital operations, medical staff leadership, and revenue cycle functions to system priorities.

- Lead change management for system-wide clinical and operational initiatives affecting patient flow, admissions, and payer performance.

- Develop and execute strategies to improve net patient revenue, reimbursement capture, and denial prevention across all facilities.

- Identify financial leakage within patient status, length of stay, and authorization workflows and implement corrective strategies.

- Oversee enterprise denial management strategy and executive-level payer escalation processes.

- Partner with contracting and revenue cycle leadership to influence payer negotiations using data, trends, and operational leverage.

- Collaborate with medical staff leadership to improve physician engagement, peer-to-peer review success, and appropriate level-of-care determinations.

- Lead initiatives connecting UM, Case Management, CDI, and Quality to improve clinical outcomes and regulatory compliance.

- Ensure regulatory readiness and accreditation performance across all facilities.

- Establish enterprise KPIs and predictive analytics to monitor performance, payer risk, and resource utilization. Oversee development of executive dashboards and decision-support tools.

- Use data to drive operational and physician behavior change.

- Evaluate and implement technology platforms supporting utilization management and care coordination.

- Provide executive oversight of Corporate and System Utilization Management leadership.

- Develop leadership capability among facility-level directors and managers.

- Build standardized workflows and governance structures across all facilities.

- Lead cross-department committees involving operations, medical staff, compliance, and revenue cycle.

- Performs other duties as assigned

**Requirements**

**Education / Experience:**

- Master’s Degree in Healthcare Administration, Nursing, Business Administration, or related field preferred.

- 10+ years of progressive healthcare leadership experience

- Multi-facility or health system leadership required

- Experience working directly with physicians and senior executives

- Demonstrated success improving reimbursement, denial reduction, or operational throughput

- Experience with behavioral health or post-acute healthcare systems preferred

- Experience with payer negotiations, value-based care, or risk-bearing models

**Skills / Abilities:**

- Enterprise strategic thinking

- Executive communication & influence

- Financial acumen

- Change leadership

- Physician relationship management

- Data-driven decision making

- Regulatory & compliance expertise

**Work Environment:**

Subject to many interruptions. Occasional pressure due to multiple calls and inquiries. This position can be high paced and stressful; must be able to cope mentally and physically to atmosphere. Work requires spending approximately 90% or more of the time inside a building that offers protection from weather conditions but not necessarily from temperature changes.

Vice President, Utilization Management

Simplifying Complex Care

Frisco, Texas-based Soleo Health is a leading national provider of complex specialty pharmacy services administered in the home or at alternate sites of care. Soleo Health’s interdisciplinary team comprises highly experienced clinical pharmacists, registered nurses, reimbursement specialists and patient care ambassadors collaborating with its referring partners.

The Company optimizes patient access solutions and delivers comprehensive services, leading to quantifiable clinical and economic value, resulting in positive patient experiences. Soleo Health has 23 pharmacy locations with national nursing coverage and pharmacy licensure in 50 states and is accredited by URAC, ACHC with Distinction in Rare Disease and Orphan Drugs and The Joint Commission. Additionally, the Company operates more than 35 infusion centers throughout the U.S.

Industry: Hospitals and Health Care
Company Size: 501-1,000 employees

Soleo Health

Job Type

Full-time

**Description**

Soleo Health is seeking a **Vice President, Business Development, Pharma Relations ** in **Frisco, TX ** to drive strategic partnerships with pharmaceutical manufacturers, expanding access to specialty and rare therapies and accelerating the Company’s growth through differentiated market access and innovation. Join us in simplifying complex care!

**Soleo Health Perks:**

- Competitive Wages

- 401(k) with a Match

- Referral Bonus

- Paid Time Off

- Great Company Culture

- Paid Parental Leave Options

- Affordable Medical, Dental, & Vision Insurance Plans

- Company Paid Disability & Basic Life Insurance

- HSA & FSA (including dependent care) Options

- Education Assistance Program

**The Position:**

The Vice President, Business Development, Pharma Relations will execute the Company’s pharmaceutical manufacturer relations strategy, with a primary focus on securing access to limited-distribution and exclusive specialty, rare, orphan, and blockbuster drugs. This individual will serve as a critical bridge between the Company and pharmaceutical manufacturers, working at the senior and executive levels to position the Company as a partner of choice for specialty drug access. In collaboration with the SVP of Business Development, Executive Team and cross-functional leaders, this role will drive initiatives that enhance our pipeline, strengthen payer alignment, and ensure long-term growth through differentiated market access. This role will report into the Senior Vice President of Business Development. **Responsibilities Include:**

- Proactively identify, target, and establish partnerships with pharmaceutical manufacturers, specifically for specialty, rare, orphan, and blockbuster therapies with limited or exclusive distribution

- Position the Company as a premier specialty pharmacy partner by articulating the value Company brings to the patient journey including clinical capabilities, patient outcomes expertise, and market reach

- Develop and implement a roadmap for winning new drug access agreements and expanding the Company’s specialty portfolio

- Monitor emerging therapeutics, pipeline developments, and competitive market dynamics in the specialty and rare drug sectors

- Translate market intelligence into actionable strategies that inform business development priorities and executive decision-making

- Represent the Company at industry conferences, advisory boards, and pharma meetings to build visibility and credibility

- Build and sustain C-suite and senior-level relationships with pharmaceutical executives, consultants, and distribution partners

- Communicate the Company’s differentiated capabilities in patient services, payor relations, enhanced data and services, and clinical outcomes to secure manufacturer confidence

- Facilitate high-impact engagements between external partners and internal stakeholders (clinical, commercial, and operational teams)

- Lead and coordinate manufacturer Requests for Proposal (RFPs), including strategy, response development, and content differentiation

- Negotiate contract terms with pharmaceutical manufacturers to ensure favorable access, margin, and growth potential

- Collaborate with internal Pharma Relations and PMO teams to ensure flawless implementation, launch, and execution of new drug programs

- Partner with sales, clinical operations, payor relations, and marketing to support seamless implementation of newly secured products

- Audit assigned programs for profitability, performance, and compliance to ensure sustainability and continuous improvement

- Work within approved budgets and growth targets, driving measurable outcomes that align with the Company’s strategic plan

- Foster a collaborative and inclusive work environment, promoting effective communication and teamwork.

**Requirements**

- Bachelor’s degree required; advanced degree preferred

- Minimum ten (10) years of experience in healthcare, with a proven track record in pharmaceutical manufacturer relations, specialty pharmacy, or biotech/rare disease commercialization

- Demonstrated success in securing limited or exclusive distribution arrangements for specialty and rare drugs

- Strong business acumen and ability to translate market opportunities into executable strategies

- Proven expertise in executive-level relationship management and contract negotiation

- Excellent presentation and communication skills, capable of influencing senior internal and external stakeholders

- Skilled in market intelligence, strategic planning, and competitive positioning in specialty pharmacy

- Competency in Microsoft Office (Excel, Word, Outlook, PowerPoint)

- Ability to travel up to 50% to meet with manufacturers, payors, and key partners

**About Us: ** Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!

**Soleo’s Core Values:**

- Improve patients’ lives every day

- Be passionate in everything you do

- Encourage unlimited ideas and creative thinking

- Make decisions as if you own the company

- Do the right thing

- Have fun!

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

Keywords: Now Hiring, Hiring Now, Hiring Immediately, Immediately Hiring

Vice President, Business Development, Pharma Relations

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