Behavioral Health Guideline Researcher (Temporary Contract)

Atlantic Health Strategies; Orlando, North Palm Beach (FL, FL); Remote; USD 45,000 - 70,000; Full time

Job summary

An established industry player in healthcare consulting is seeking a Behavioral Health Payer Guideline Researcher for a short-term contract. This role involves in-depth research into payer compliance guidelines and engaging with provider relations at health plans. Ideal candidates will have a strong background in behavioral health terminology and experience in payer relations. The position is fully remote, requiring excellent communication skills, critical thinking, and the ability to conduct thorough phone-based research. This is a fantastic opportunity to contribute to impactful projects in the behavioral health sector.

Qualifications

• Strong familiarity with ASAM criteria and documentation expectations.
• Experience in payer relations or compliance documentation.

Responsibilities

• Conduct in-depth research into payer-specific compliance guidelines.
• Call provider relations departments to clarify credentialing and documentation.

Skills

Behavioral Health Terminology

Payer Relations

Utilization Review

Research Skills

Communication Skills

Critical Thinking

Tools

Microsoft Excel

Job description

Atlantic Health Strategies is a nationally recognized healthcare consulting firm specializing in behavioral health and substance use disorder treatment. We provide expert advisory services to providers across the country in the areas of licensure, accreditation, payer relations, and operational compliance.

We are currently seeking a Behavioral Health Payer Guideline Researcher on a short-term contract to support our payer compliance and reimbursement mapping initiatives. This is a contractor position (not a W-2 role) and will run on a project basis with the potential for recurring work depending on performance and project volume.

Key Responsibilities:

• Conduct in-depth research into payer-specific compliance guidelines for behavioral health services (Mental Health & SUD).
• Call provider relations departments at national and regional health plans to clarify credentialing, documentation, and authorization requirements.
• Extract criteria from InterQual, MCG, and ASAM guidelines where payer-specific versions are referenced.
• Summarize findings in clear, structured formats for internal team use and client-facing tools.
• Ensure accuracy and relevance of regulatory interpretations for Mental Health and Substance Use Disorder Treatment levels of care.
• Collaborate with our internal compliance and clinical operations team to validate and update content.
  
  

Required Qualifications:

• Strong familiarity with behavioral health terminology, including ASAM criteria, LOCUS, and documentation expectations.
• Experience in payer relations, utilization review, or compliance documentation.
• Ability to speak confidently and professionally by phone with insurance plan representatives and medical policy teams.
• Proficiency in Microsoft Excel and structured data entry.
• Self-starter with strong research, critical thinking, and written communication skills.
• Prior work in behavioral health, revenue cycle, or managed care preferred.
  
  

Scope and Terms:

• Independent Contractor (1099)
• Approx. 20 hours per week to start, with potential for additional work based on need.
• Fully remote; must be U.S.-based and authorized to work as an independent contractor.
• This is a temporary, project-based role and not a permanent position.

Role Note:
We love online research, but this role is not an online research role. This is a research role that requires time on the phone, reaching out to provider representatives at insurance companies to seek regulatory interpretation. If you do not like talking on the phone or get frustrated navigating complex call trees or being told you are speaking to the wrong department this role is not for you.

This role is for you if you are determined, like speaking on the phone, know how to ask meaningful questions to get the answers you need, and can log the source for the data you collect. Because this role requires speaking to departments at insurance companies it can not be done solely on evenings or weekends, and will require business hours availability. This is not a UR role, it is a research role around specific guidelines, but a background in behavioral health utilization review or compliance is relevant.

How to Apply:

Send your resume and a short cover letter describing your experience with payer guideline research and behavioral health compliance, or utilization management. Please include any relevant examples of payer interactions or documentation work.