The opportunity

Gresham Executive is partnering with a high-growth addiction treatment platform in New Jersey on a search for an experienced Chief Operating Officer. The business operates an inpatient detox and residential program alongside an outpatient facility, and is at an inflection point in its growth.

This is a rare opportunity to step into a well-capitalized operation and take full ownership of day-to-day performance with significant autonomy.

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The role

·      Own all day-to-day operations across inpatient detox, residential, and outpatient services

·      Drive census growth, operational efficiency, and margin performance as the business scales

·      Oversee admissions, clinical operations, revenue cycle, billing, compliance, and staffing

·      Build and hold accountable a leadership team across all operational functions

·      Partner directly with the founder on strategic direction and expansion planning

Must-have experience

·      Out-of-network billing expertise is the single most important requirement for this role. Candidates without direct OON experience in behavioral health will not be considered.

·      Proven track record operating or scaling a detox, residential, or inpatient behavioral health program

·      Deep understanding of out-of-network payer dynamics, utilization review, and reimbursement strategy

·      Experience managing or rebuilding revenue cycle operations and driving collections performance

·      Strong grasp of cash flow management in an OON environment (delayed, variable reimbursement cycles)

·      Hands-on leadership style - comfortable managing across clinical, administrative, and billing teams

The right person

·      Comfortable in high-growth, fast-moving environments with ambiguity and pressure

·      Thrives with accountability and autonomy; doesn't need a process handed to them

·      Strong enough presence to hold a clinical team, admission team, and billing team to the same standard

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