Health Plan Contract Manager

Community Bridges, INC•Mesa, AZ

About The Position

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.

Requirements

Bachelor’s Degree in Business Administration or Healthcare Management, or a related field required.
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.
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.

Nice To Haves

Master’s in Business Administration or Public Administration preferred.
Three (3) or more years of experience with rate setting and analysis preferred.
Commercial Health plan contracting experience and building relationships preferred.
Accountable Care Organization experience preferred.
Multi-state healthcare payer strategy or contracting experience preferred.

Responsibilities

Contracting healthcare services provided by Community Bridges, Inc. (CBI) with Medicaid, Medicare and Commercial payers, and government entities (e.g. counties, cities, other municipalities)
Serves as the point of contact for internal inquiries regarding health plan contract needs
Implements contracting strategies identified by the Executive Leadership Team (ELT)
Works collaboratively with all internal departments to ensure there is awareness and knowledge of contracts and contract requirements
Participates in payer Joint Operations Committee (JOC) meetings and is position is also involved in contracts with Accountable Care Organizations
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
Responsible for establishing the necessary structures for tracking and monitoring contracts through the lifespan to ensure contracts are current

Benefits

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.
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 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!