Health Plan Contract Manager

Community Bridges; Phoenix (AZ); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

5 weeks PTO

Medical, Dental, Vision

401K with employer match

Tuition reimbursement

Job summary

Community Bridges, Inc. (CBI) is seeking a Health Plan Contract Manager to oversee contracting with Medicaid, Medicare, Commercial payers and government entities.

The role requires coordinating with internal teams to ensure contracts meet requirements and are updated as needed. The ideal candidate will have a Bachelor's in Business Administration or Healthcare Management, 5+ years in healthcare contract management with rate setting experience, and AHCCCS familiarity.

Qualifications

• Bachelor’s degree in Business Administration or Healthcare Management required.
• Five (5) or more years of contract management/negotiation in healthcare required.
• Experience with rate setting and analysis required.
• AHCCCS health plan contracting experience strongly preferred.
• Knowledge of Medicaid, Medicare and Commercial systems and related regulations preferred.

Responsibilities

• Contract healthcare services with Medicaid, Medicare, Commercial payers and government entities.
• Act as the primary contact for health plan contract inquiries across internal teams.
• Implement contracting strategies identified by ELT and ensure contract knowledge is disseminated internally.
• Participate in payer Joint Operations Committee meetings and work with AP/Legal for amendments.
• Establish structures to track and monitor contracts through their lifespan.

Skills

Leadership experience

Contract management

Rate setting

AHCCCS contracting

Medicaid/Medicare knowledge

Multi-stakeholder collaboration

Education

Bachelor’s Degree in Business Administration or Healthcare Management

Master’s in Business Administration or Public Administration preferred

Job description

Community Bridges, Inc. (CBI) is an integrated behavioral healthcare agency offering a variety of different programs throughout Arizona. CBI provides residential, outpatient, inpatient, patient-centered medical homes, medication-assisted treatment, and crisis services to individuals experiencing crisis, opioid use disorder, homelessness, and mental illness.

Health Plan Contract Manager

Community Bridges, Inc. (CB I) is an integrated behavioral healthcare agency offering a variety of different programs throughout Arizona. CBI provides residential, outpatient, inpatient, physical health, medication-assisted treatment, and crisis services to individuals experiencing, substance use disorder, homelessness, and mental illness.

CBI is the premiere non-profit fully integrated healthcare provider of substance use and behavioral health programs in Arizona, including prevention, education and treatment using cutting-edge, nationally recognized, evidence-based models.

Job Summary

The Health Plan Contract Manager is a key contributor whose primary responsibility is contracting healthcare services provided by Community Bridges, Inc. (CBI) with Medicaid, Medicare and Commercial payers, and government entities (e.g. counties, cities, other municipalities). The manager serves as the point of contact for internal inquiries regarding health plan contract needs, implements contracting strategies identified by the Executive Leadership Team (ELT) and works collaboratively with all internal departments to ensure there is awareness and knowledge of contracts and contract requirements. The manager also participates in payer Joint Operations Committee (JOC) meetings and is position is also involved in contracts with Accountable Care Organizations. The administrator works closely with the VP Payer Relations to provide status updates on contracting opportunities, existing contracts that require amendments, and ensure legal review is completed prior to recommending signature. This position is also responsible for establishing the necessary structures for tracking and monitoring contracts through the lifespan to ensure contracts are current.

Skills/Requirements

• Bachelor’s Degree in Business Administration or Healthcare Management, or a related field required. Master’s in Business Administration or Public Administration preferred.
• Two (2) or more years of leadership experience is required.
• Five (5) or more years of experience in contract management/negotiation of healthcare contracts (Behavioral Health, Addiction, Integrated Care) in multiple settings (e.g. outpatient, facility, physician/provider, etc.) required.
• Experience with rate setting and analysis required. o Three (3) or more years of experience with rate setting and analysis preferred.
• Working knowledge in key healthcare operations (e.g., claims/billing, coding, credentialing required.
• AHCCCS Health plan contracting experience strongly preferred.
• Knowledge of healthcare industry – statutes and regulations in Medicaid, Medicare, and Commercial systems; knowledge of behavioral health, addiction and physical health services strongly preferred.
• Knowledge of multiple reimbursement strategies: FFS, Pay for Performance, Full Risk strongly preferred.
• Knowledge of ACOs and contracting with ACOs strongly preferred.
• Commercial Health plan contracting experience and building relationships preferred.
• Accountable Care Organization experience preferred.
• Multi-state healthcare payer strategy or contracting experience preferred.

CBI Offers an excellent benefits package!

• Generous PTO accrual (5 weeks!),
• Medical, Dental, Vision, Disability, Life, Supplemental plans
• Hospital indemnity/ Critical Illness,
• Pet Insurance,
• Dependent Care Savings, Health Care Savings,
• 401K with employer match - 100% vested upon enrollment,
• Wellness programs,
• Tuition Reimbursement and Scholarship Programs, incentives, and more!
• Very Competitive pay rates

CBI is growing and expanding our services!

• We are experiencing tremendous growth in this time. As an essential service provider, we value all our employees and their careers.
• *For the past four years, The Phoenix Business Journal has recognized CBI as one of the top ten healthiest mid-size employers in the Valley! *

CBI Values your Career and have lots of growth opportunities!

Our staff experience tremendous professional growth through ongoing training and support. Our team is supported by strong and competent leadership. The leadership at CBI is committed to ongoing professional development for their staff. Come join our team of passionate individuals who are serious about making a difference in the lives of our patients and the communities we serve.

About our Culture, commitment to employees!

• We are looking for driven and compassionate individuals that thrive in an upbeat and safe working environment. We dedicate a lot of thought and effort into work life balance as well as our competitive composition structure.
• We know life happens, that’s why we all start with a 5-week PTO plan as well as a wide range of unique benefits!

Our Facilities.

Our 26 locations are all state-of-the-art facilities that provides top notch integrated care. We are proud to adhere to a “no wrong door” treatment approach that allows our staff to dramatically improve the quality of life for the patients in their care.

CBI treats patients from all different walks of life and believes in maintaining the dignity of human life. Recovery is possible!

CBI Offers an excellent benefits package!

• Medical, Dental, Vision, Disability, Life, Supplemental plans - Hospital indemnity/ Critical Illness, Pet Insurance, Dependent Care Savings, Health Care Savings, 401K with employer match - 100% vested upon enrollment, Generous PTO accrual, Wellness programs, Tuition Reimbursement and Scholarship Programs, incentives, and more!
• For the past four years, The Phoenix Business Journal has recognized CBI as one of the top ten healthiest mid-size employers in the Valley.

CBI treats patients from all different walks of life and believes in maintaining the dignity of human life. Recovery is possible!