VP of Operations & Strategy

About ORCA Rehab

ORCA Rehab is a rapidly growing, physician-founded and physician-led healthcare organization specializing in Physical Medicine & Rehabilitation (PM&R) and physician services across skilled nursing facilities, hospitals, inpatient rehabilitation facilities, and other post-acute settings throughout California.

A significant portion of our organization operates within the skilled nursing and post-acute environment. Our physicians and advanced practice providers work across a large and growing network of facilities, requiring close coordination among providers, facility leadership, operations, credentialing, scheduling, revenue cycle, HR, recruiting, and administrative teams.

As ORCA continues to expand, we are looking for an exceptional healthcare operator who can help our founders build the organization and operating infrastructure necessary for our next stage of growth.

This is not a traditional corporate VP position, and it is not a Practice Manager position.

We are looking for a hands-on, highly resourceful leader who can see the organization as a whole, identify what needs to be built or fixed, coordinate the right people, and make sure important initiatives actually get done.

For the right individual, this role has the potential to develop into a Chief Operating Officer position as ORCA continues to grow.

The Role

ORCA has reached a stage where our growth and organizational complexity require another level of operational leadership.

We already have capable leaders responsible for day-to-day practice operations and individual functional areas. We are not looking for someone to take over routine scheduling, administrative tasks, or daily practice management.

Instead, the VP of Operations & Strategy will operate above and across those functions.

This individual will work directly with ORCA's founders to:

• Translate company priorities into executable plans
• Coordinate leaders and departments around major initiatives
• Establish clear ownership, timelines, and accountability
• Solve complex cross-functional problems
• Build scalable systems and processes
• Lead expansion into new facilities and markets
• Identify organizational gaps before they become larger problems
• Ensure important initiatives reach completion without constant founder follow-up

If ORCA decides to enter a new market, launch 10–15 new skilled nursing facilities, restructure an inefficient process, address a significant operational problem, or build a new companywide system, this person should be capable of taking that objective and driving it from idea through execution.

We are looking for an operator and builder, not simply an administrator.

SNF & Post-Acute Experience Strongly Preferred

Direct experience within skilled nursing facilities and/or post-acute healthcare is strongly preferred and will be given significant consideration in our selection process.

ORCA operates extensively within SNFs. We strongly value leaders who understand how these facilities actually operate and the unique challenges of delivering physician services across multiple independently operated facilities.

Particularly relevant backgrounds include:

• Skilled nursing facility operations
• Regional or divisional leadership for multi-facility SNF organizations
• Physician groups providing services within SNFs
• Post-acute healthcare organizations
• Healthcare MSOs
• Rehabilitation organizations
• Multi-site physician practices
• Home health or hospice
• Other decentralized healthcare organizations

Experience working directly with SNF administrators, regional operators, Directors of Nursing, MDS teams, rehabilitation departments, medical directors, physicians, APPs, and facility ownership groups is particularly valuable.

Familiarity with Medicare, managed care, provider productivity, facility census, credentialing, reimbursement, revenue cycle, clinical documentation, and PDPM is highly desirable.

We are particularly interested in candidates who understand the SNF environment from actual operating experience, not solely from a corporate or analytical perspective.

This Is a Hands-On Operating Role

This distinction is extremely important to us.

We are not looking for someone whose primary contribution is sitting at a desk reviewing dashboards, interpreting data, preparing presentations, attending meetings, and telling other people what the numbers mean.

Data matters, but only when it leads to action.

When a metric indicates a problem, we want someone whose instinct is to determine what is actually happening behind that number.

If collections decline, we do not simply want a report showing that collections declined. We want someone who will work with Revenue Cycle, Operations, providers, and vendors to determine why, establish corrective action, assign ownership, and make sure the problem gets resolved.

If credentialing is delaying a facility launch, we want someone who will determine where the process is breaking down and get the launch back on track.

If a department repeatedly misses deadlines, we want someone who will determine whether the underlying problem is staffing, workflow, leadership, accountability, technology, communication, or something else and address it.

If a new SNF partnership is not performing as expected, we want someone willing to speak directly with the people involved, visit the facility when appropriate, understand what is happening on the ground, and develop a solution.

The ideal candidate can move comfortably between strategy and execution, between the office and the field, and between analyzing a problem and personally helping solve it.

Success is not producing the analysis.

Success is making the organization better because of what you discovered.

KEY RESPONSIBILITIES

Enterprise Operations & Execution

• Work directly with ORCA's founders to establish companywide priorities
• Translate strategic objectives into operational plans
• Establish clear ownership, deadlines, deliverables, and measurable outcomes
• Coordinate major initiatives across Operations, HR, Revenue Cycle, Accounting/Finance, credentialing, recruiting, and provider operations
• Ensure projects continue moving without repeated founder intervention
• Identify bottlenecks and resolve gaps between departments
• Hold department leaders accountable while avoiding unnecessary micromanagement
• Identify operational problems early and drive corrective action
• Escalate matters to the founders when executive decisions are genuinely required
• Reduce organizational dependence on the founders for routine operational execution

Growth & New Market Expansion

• Evaluate the operational feasibility of new facilities, markets, partnerships, and service lines
• Develop implementation plans for approved expansion
• Coordinate provider recruiting, credentialing, payer enrollment, scheduling, billing readiness, and operational workflows
• Establish launch timelines, responsibilities, dependencies, and go-live criteria
• Coordinate multiple departments during new facility and market launches
• Monitor performance after launch and address early problems
• Help determine whether ORCA has the operational capacity to pursue new opportunities

For example, if ORCA signs 10–15 SNFs in a new geographic market and needs to begin services within 60 days, this person should be capable of building and driving the operational roadmap necessary to make that happen.

Leadership & Accountability

• Coordinate department leaders around companywide priorities
• Clarify responsibilities and decision-making authority
• Develop measurable goals and KPIs
• Create accountability for commitments and deadlines
• Identify leadership or departmental performance problems
• Coach and develop managers and department leaders
• Resolve cross-functional barriers
• Make recommendations regarding organizational structure, staffing, and leadership needs
• Build a culture where leaders take ownership rather than automatically escalating problems to the founders

Operational Problem Solving

We want someone who genuinely enjoys figuring out why things are not working.

You may encounter issues involving:

• Revenue cycle and collections
• A/R and denials
• Provider productivity and capacity
• Credentialing delays
• Scheduling inefficiencies
• Facility launches
• Vendor performance
• Cross-department communication
• Projects repeatedly missing deadlines
• Facility complaints
• Provider workflow problems
• Administrative inefficiencies
• Technology and systems
• Increasing expenses or operational inefficiencies

The expectation is not simply to identify or report these problems.

The expectation is to help solve them.

Systems & Scalability

• Build practical, scalable operational workflows
• Develop and improve SOPs where appropriate
• Establish useful dashboards and KPIs
• Improve communication and project management
• Clarify escalation pathways
• Improve cross-functional coordination
• Identify appropriate opportunities for automation and technology
• Eliminate unnecessary administrative work
• Standardize processes when standardization creates value
• Preserve flexibility where excessive structure would create bureaucracy

We do not believe every problem requires another meeting, committee, policy, or management layer.

We want someone with the judgment to know the difference.

Working With the Founders

The VP of Operations & Strategy will work closely with ORCA's physician founders.

The founders will remain focused on strategy, clinical direction, major facility and physician relationships, partnerships, business development, new markets, capital allocation, and significant organizational decisions.

We want this leader to progressively take ownership of the execution surrounding those priorities.

A productive update to the founders should increasingly look like:

“Here are the most important things happening.”

“These issues have already been handled.”

“This project is behind schedule. I determined why, and here is what we're doing about it.”

“Here are the two decisions I need from you.”

We want an independent thinker who is comfortable respectfully challenging the founders when their judgment, experience, or the operational reality points toward a different conclusion.

Once a decision is made, however, this person should be capable of turning that decision into action.

Who Will Thrive at ORCA

You are likely to succeed here if:

• You consider yourself an operator and builder
• You understand SNFs and post-acute healthcare
• You are strategic but remain highly hands-on
• You use data as a starting point, not the final product
• When a metric looks wrong, you want to understand the workflow behind it
• You are willing to leave your desk and talk directly with the people doing the work
• You are comfortable visiting facilities and seeing operations firsthand
• You can move between strategic planning and detailed problem solving
• You know when to delegate and when to personally get involved
• You can manage and challenge other leaders
• You take ownership of ambiguous problems
• You naturally follow through until something is finished
• You are resourceful and comfortable making decisions without perfect information
• You prefer practical solutions over unnecessarily complicated ones
• You can create structure without creating bureaucracy
• You enjoy working in an entrepreneurial, founder-led environment

This Role May Not Be the Right Fit If...

• You are primarily looking for a traditional corporate executive position
• You prefer spending most of your time reviewing dashboards, reports, presentations, and analytics
• Your primary management style is interpreting information and delegating recommendations
• You believe executive leadership means staying above operational details at all times
• You prefer managing exclusively through multiple layers of management
• You require extensive corporate infrastructure to operate effectively
• You are uncomfortable personally investigating operational problems
• You are uncomfortable working directly with frontline teams or facility leadership
• You believe most organizational problems require additional meetings, committees, or policies
• You prefer managing an established system rather than helping build one
• You are primarily motivated by title rather than ownership, responsibility, and impact

Qualifications

• 8+ years of progressive healthcare operations experience preferred
• Significant leadership experience in a multi-site healthcare organization
• SNF/post-acute healthcare experience strongly preferred
• Experience managing managers, directors, or department leaders
• Experience working with physicians and APPs preferred
• Experience launching new facilities, markets, locations, or service lines strongly preferred
• Demonstrated ability to lead complex projects from concept through implementation
• Strong understanding of healthcare operational and financial metrics
• Familiarity with healthcare reimbursement and revenue cycle
• Strong analytical skills combined with demonstrated operational execution
• Excellent judgment and problem-solving ability
• Strong project-management and organizational skills
• Ability to independently investigate complex operational problems
• Strong written and verbal communication
• High level of ownership and personal accountability
• Bachelor's degree required
• MBA, MHA, MPH, or similar graduate degree preferred but not required

Demonstrated operating ability, judgment, leadership, and execution are substantially more important to us than credentials alone.

First 90 Days

The successful candidate will be expected to:

• Learn ORCA's clinical and business model
• Spend meaningful time understanding how our providers operate within SNFs
• Visit representative partner facilities
• Meet ORCA's department leaders and understand existing responsibilities
• Review major operational workflows and identify gaps or overlap
• Understand revenue cycle, credentialing, provider operations, recruiting, and facility-launch processes
• Review current KPIs and determine what is actually happening behind the numbers
• Identify the organization's most important operational bottlenecks
• Identify areas where the founders remain unnecessarily involved
• Recommend and begin implementing high-priority improvements
• Establish clear ownership for major initiatives
• Take direct ownership of several significant cross-functional projects and drive them toward completion

We expect thoughtful learning, but we do not expect a senior operating leader to spend six months observing before making an impact.

Relationship With Existing Leadership

This role is not intended to duplicate ORCA's existing Practice Manager or functional department leaders.

Day-to-day practice operations remain with the leaders responsible for those functions.

The VP of Operations & Strategy operates above and across those functions, particularly when an issue or initiative requires coordination among multiple departments.

Put simply:

The Practice Manager helps run today's operation.

The VP of Operations & Strategy helps build, coordinate, improve, and scale the organization around it.

Potential Path to COO

ORCA's continued growth will ultimately require a strong enterprise-level operating executive.

For an exceptional performer who demonstrates the judgment, leadership, execution, and ability to operate effectively alongside the founders, this position may develop into a broader executive leadership role, including a potential path to Chief Operating Officer.

That progression would be earned through demonstrated performance and increasing responsibility rather than title or tenure alone.

Location & On-Site Requirement

This is a full-time, 100% on-site position based at ORCA Rehab's administrative office in Irvine, California.

This is not a remote or hybrid position. The VP of Operations & Strategy is expected to work on-site Monday through Friday and maintain a regular in-person presence with ORCA's founders, leadership team, and staff.

Because this is a hands-on operational leadership position, the role will also require periodic travel to ORCA's skilled nursing facility partners and other sites throughout California. As ORCA expands, occasional travel to additional markets may be required.

Compensation

Expected base salary: $170,000–$200,000 annually, depending on experience, directly relevant SNF/post-acute background, demonstrated operating capabilities, and overall scope.

Performance-based incentive compensation may also be available.

Why ORCA?

This is an opportunity for someone who wants to help build an organization rather than simply inherit one.

ORCA has already established a strong clinical platform, provider network, facility footprint, and foundation for continued growth.

Our next challenge is building the operational infrastructure that allows the company to become substantially larger without requiring the founders to personally coordinate every important initiative.

For the right person, this is an opportunity to have a meaningful influence on how ORCA is built over the coming years and potentially grow into the operating executive who helps lead the company's next stage.

Pay: $150,000.00 - $200,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Application Question(s):

• Are you willing and able to work full-time, 100% on-site in Irvine, California, Monday through Friday, with periodic travel to facilities throughout California?
• Have you directly managed managers, directors, or other department leaders within a healthcare organization?
• Have you personally led the launch, expansion, or implementation of healthcare operations across multiple facilities, locations, or markets?
• Have you personally taken ownership of and resolved significant operational problems rather than serving primarily in an analytical, advisory, or reporting role?
• Have you worked directly with skilled nursing facility administrators, clinical leadership, or regional SNF operators as part of your operational responsibilities?

Education:

• Bachelor's (Required)

Experience:

• Skilled nursing facility: 2 years (Preferred)
• multi-site operation: 2 years (Required)
• Senior leadership: 2 years (Required)

Ability to Commute:

• Irvine, CA 92606 (Required)

Work Location: In person

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