Behavioral Healthcare Contracts Director
About The Position
The Contracts Director plays a pivotal role in Helio Health's continued expansion throughout Upstate NY. Qualified candidates will have experience with all aspects of behavioral health contracting with NY State Medicaid, Medicare, Managed Care and Commercial lines of business. Knowledge and experience with payor contracts relevant to multiple health program service types, contract reimbursement strategy, and communication with provider representative and NY State agencies is strongly preferred. If you are a skilled negotiator with a passion for driving results for our program participants, we would love to review your qualifications! The mission of Helio Health, Inc. is: To promote recovery from the effects of substance use and mental health disorders and other health issues. To support the mission of Helio Health, Inc., the Contracts Director will be responsible for communication, negotiation, management and implementation of all Health Insurance Contracts (including Medicaid, Medicare, Managed Care, Commercial and other guarantor plans). This position will work Full-Time out of our Revenue Cycle Management department.
Requirements
- Bachelor’s Degree in Healthcare, Business Administration or related field is required.
- Three years experience in healthcare, managed care and healthcare contract negotiations preferred.
- Prior experience working with all levels of organization, including senior management and physicians.
- Strong project management, leadership, quantitative and analytical skills.
- Must have excellent written and oral communication skills.
- Capable of working toward specific strategic objectives and managing deadlines.
- Exceptional IT skills with knowledge of Excel and other Microsoft Office products.
- Must possess negotiation skills.
- Must have a valid NYS Driver’s License.
Nice To Haves
- Knowledge and experience with payor contracts relevant to multiple health program service types, contract reimbursement strategy, and communication with provider representative and NY State agencies is strongly preferred.
Responsibilities
- Manage, communicate, and monitor contract terms.
- Review and pursue contracting opportunities for additional patient coverage of services, including single case agreements as needed.
- Develop resource and reference material to be shared internally and externally as it applies to contract reimbursement.
- Work with Director of Revenue Cycle Management as a liaison between the managed care plans and agency.
- Work with the Chief Revenue Officer and RCM Leadership Team to analyze payment trends and develop contracting strategies.
- Work with the RCM Managers of Billing, UCM and PAS follow up on issues and corrections on Explanation of Benefits
- Provide support to other departments as directed by Supervisor.
- Negotiate Insurance Contracts.
- Initiate and update, and credentialing, re-credentialing/revalidation for all plans, including communication and documentation for new programs.
- Maintain ETINS, MMIS and other critical documentation and applications as required by eMedNY and NYS Department of Health.
- Maintain and update agency data base of fee schedules by payor.
- Other duties as assigned.
Benefits
- Health insurance including dental and vision for employees and families.
- Paid Vacation and Sick leave - No Waiting Period for accruals.
- Paid holidays, including a floating birthday holiday.
- 401(k) plan with up to 5% company match.
- Company paid short-term disability insurance.
- Company sponsored life insurance.
- Employee Assistance Program (EAP).
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What This Job Offers
Job Type
Full-time
Career Level
Manager
