Behavioral Health Account Manager
for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. We need to parse the job posting.
We have a job profile summary with many responsibilities. Also minimum qualifications, preferred qualifications, hiring range (pay), benefits mentioned. No schedule info. So we should include sections: About the role (maybe from summary), Responsibilities (list of duties), Requirements (minimum qualifications), Qualifications (maybe preferred qualifications?), Skills (maybe combine?), Benefits, Pay. Schedule not present, so omit.
We must not repeat job title as heading. No Job ID etc. Remove boilerplate like compliance & regulatory responsibilities NA etc. Also remove "Hiring Range*: Greater New York City Area..." but we need pay section with that info. Also benefits description.
We need to preserve all substantive info, not invent. Use - for any list of duties/requirements/benefits. Use
for prose.
We need to decide which content goes where.
About the role: Could be the first paragraph summarizing role: "Under the direction of the Manager of Behavioral Health Network and Contracting, the Behavioral Health Account Manager assists in the development and maintenance of a Behavioral Health provider network that ensures Healthfirst members have superior access to the highest quality, cost-effective providers of Behavioral Healthcare services in compliance with Medicare, Medicaid, the Health and Recovery Plan (HARP) and others. The individual must possess experience working closely with providers or in a managed care setting. The ideal candidate will have experience in Behavioral Health network development, provider recruitment, provider education and contract negotiations. This position works closely cross-functionally with Network Management, Credentialing and Business Analytics to maximize operational and financial efficiency. Medicaid experience preferred. Extensive field work is required. The Behavioral Health Account Manager will represent and advance Healthfirst’s interests in the Behavioral Health provider market as the preeminent plan in the NYC marketplace through first-rate customer service and execution of provider engagement strategies. This position will advance Healthfirst in the Behavioral Health provider market."
That's a lot; we can keep as prose.
Responsibilities: list of duties: "Assists in the development and recruitment of the Behavioral Health network based on department needs and Healthfirst priorities. Negotiates and executes Single Patient Agreement for Out of Network providers in order to determine the provider’s payment arrangement. Individual must be familiar with or have the ability to learn contracting and reimbursement methodologies for inpatient and outpatient services. Conducts comprehensive provider network training onsite, through webinars, or at off-site provider locations that will support network providers in gaining appropriate knowledge, skills and technical expertise ultimately ensuring providers understand and are compliant with managed care requirements. Organizes provider training materials and education of BH providers ensuring that providers understand any new services or initiatives including the following: Behavioral Health- Home and Community Based Services (HCBS), Recovery Coordination Agencies, Children’s Family Treatment and Support Services. Responsible for the creation of various Microsoft PowerPoint presentations and other documents. Educate providers on Healthfirst policies and procedures such as billing, authorization, utilization of Healthfirst’s provider portal, claims inquiries, etc. Conducts initial provider orientation. This orientation is also available periodically via webinar. Topics will include: expanded array of benefits, Health Homes, Claims, Authorizations, Cultural Competency, Evidence Based Practices, Utilization Management, HCBS eligibility/assessment and the secure provider portal. Assists in obtaining credentialing documentation for new providers, distributes and collects executed contracts, distributes provider communication and provides network maintenance to ensure access and availability standards such as travel time/distance to BH Providers, are adequate and compliant. Reviews provider issues and performs root cause analysis by operating in an analytical framework, resolving provider’s issues and ensuring timely and positive outcomes. Appropriately escalates critical and other concerns that the Provider may have in order to resolve issues accordingly. Provides internal support for the resolution of operational problems as they pertain to the contracting process, claims payments and/or BH provider contracts. Participates in meetings by providing analysis, feedback and recommendations that foster a successful relationship between Healthfirst, external agencies and essential providers. Monitors and conducts regular audits as needed of contracted behavioral networks to ensure that accurate information such as demographics, payment and fee schedules are loaded into Healthfirst’s systems appropriately. Resolves configuration issues when identified to prevent further claim denials."
We can break into bullet list.
Requirements: Minimum Qualifications: "High School Degree/GED, Experience and understanding of health care reimbursement methodologies, Knowledge of Medicare and Medicaid products, Must have either: Behavioral Health, network development, provider relations or provider education experience, Ability to travel to various NY boroughs as needed (car not required), Experience with Microsoft Outlook or similar calendar management, Demonstrated ability to multi-task, prioritize and use good judgement in a fast-paced environment."
Qualifications: Preferred Qualifications: "Bachelor’s Degree, Previous experience in a managed care environment working closely with providers, Ability to take initiative and work independently in a dynamic environment, Strong customer-centric and analytical skills, Excellent oral and written communication skills, Strong presentation and problem-solving skills, Valid driver's license and insured automobile, Familiar with root cause analysis"
Skills: Could combine some skills from preferred qualifications? But we already have qualifications sections. Maybe we can treat "Skills" as separate for things like "Strong presentation and problem-solving skills, Strong customer-centric and analytical skills, Excellent oral and written communication skills, Ability to multi-task, prioritize, use good judgement". However we already have those in qualifications. To avoid duplication, maybe we omit Skills section if content overlaps. But instructions: Prefer a few substantive sections over many thin ones. We could combine Requirements and Qualifications into one? But they ask to use headings for those specific names if content exists. We have both minimum and preferred qualifications; we could put them under Requirements (minimum) and Qualifications (preferred). Skills maybe not needed.
Benefits: "In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live."
Pay: "Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $68,900 - $99,620; All Other Locations (within approved locations): $61,300 - $91,120. As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision."
We should not include the asterisk note? It's part of posting; we can keep.
Schedule: none, omit.
Now produce HTML fragment.
We need to wrap each section:
About the role
...
etc.
For lists: - ...
.
We need to ensure we don't include any boilerplate like "Compliance & Regulatory Responsibilities: NA License/Certification: NA". Remove.
Also remove duplicated lines.
Let's craft.
About the role paragraph: combine first few sentences up to "Medicaid experience preferred. Extensive field work is required." plus the representation sentence.
I'll write a concise but preserving all substantive info.
Let's draft:
Under the direction of the Manager of Behavioral Health Network and Contracting, the Behavioral Health Account Manager assists in the development and maintenance of a Behavioral Health provider network that ensures Healthfirst members have superior access to the highest quality, cost‑effective providers of Behavioral Healthcare services in compliance with Medicare, Medicaid, the Health and Recovery Plan (HARP) and others. The individual must possess experience working closely with providers or in a managed care setting. The ideal candidate will have experience in Behavioral Health network development, provider recruitment, provider education and contract negotiations. This position works closely cross‑functionally with Network Management, Credentialing and Business Analytics to maximize operational and financial efficiency. Medicaid experience preferred. Extensive field work is required. The Behavioral Health Account Manager will represent and advance Healthfirst’s interests in the Behavioral Health provider market as the preeminent plan in the NYC marketplace through first‑rate customer service and execution of provider engagement strategies. This position will advance Healthfirst in the Behavioral Health provider market.
Now Responsibilities list: each duty as - . We'll break into items.
I'll create list items:
- Assists in the development and recruitment of the Behavioral Health network based on department needs and Healthfirst priorities.
- Negotiates and executes Single Patient Agreement for Out‑of‑Network providers to determine the provider’s payment arrangement.
- Must be familiar with or able to learn contracting and reimbursement methodologies for inpatient and outpatient services.
- Conducts comprehensive provider network training onsite, via webinars, or at off‑site locations to ensure providers gain appropriate knowledge, skills and technical expertise and remain compliant with managed care requirements.
- Organizes provider training materials and educates BH providers on new services or initiatives, including Behavioral Health‑Home and Community Based Services (HCBS), Recovery Coordination Agencies, and Children’s Family Treatment and Support Services.
- Creates Microsoft PowerPoint presentations and other documents; educates providers on Healthfirst policies and procedures such as billing, authorization, utilization of the provider portal, claims inquiries, etc.
- Conducts initial provider orientation (also available periodically via webinar) covering expanded array of benefits, Health Homes, Claims, Authorizations, Cultural Competency, Evidence Based Practices, Utilization Management, HCBS eligibility/assessment, and the secure provider portal.
- Assists in obtaining credentialing documentation for new providers, distributes and collects executed contracts, distributes provider communication, and provides network maintenance to ensure access and availability standards (e.g., travel time/distance to BH providers) are adequate and compliant.
- Reviews provider issues, performs root cause analysis using an analytical framework, resolves issues, and ensures timely and positive outcomes.
- Appropriately escalates critical and other provider concerns to achieve resolution.
- Provides internal support for resolving operational problems related to the contracting process, claims payments, and/or BH provider contracts.
- Participates in meetings by providing analysis, feedback, and recommendations that foster successful relationships between Healthfirst, external agencies, and essential providers.
- Monitors and conducts regular audits of contracted behavioral networks to verify that demographics, payment, and fee schedules are correctly loaded into Healthfirst’s systems; resolves configuration issues to prevent further claim denials.
Now Requirements (minimum qualifications) list:
- High School Degree or GED
- Experience and understanding of health care reimbursement methodologies
- Knowledge of Medicare and Medicaid products
- Must have experience in either Behavioral Health, network development, provider relations, or provider education
- Ability to travel to various NY boroughs as needed (car not required)
- Experience with Microsoft Outlook or similar calendar management
- Demonstrated ability to multi‑task, prioritize, and use good judgement in a fast‑paced environment
Now Qualifications (preferred) list:
- Bachelor’s Degree
- Previous experience in a managed care environment working closely with providers
- Ability to take initiative and work independently in a dynamic environment
- Strong customer‑centric and analytical skills
- Excellent oral and written communication skills
- Strong presentation and problem‑solving skills
- Valid driver’s license and insured automobile
- Familiar with root cause analysis
Now Benefits list:
- Medical, dental, and vision coverage
- Incentive and recognition programs
- Life insurance
- 401(k) contributions
(All benefits subject to eligibility requirements.)
We could also include statement about competitive compensation and benefits package as prose.
Now Pay section: we can put as
with the hiring range details.
Let's craft:
Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $68,900 – $99,620; All Other Locations (within approved locations): $61,300 – $91,120. Salary and related elements of compensation are contingent upon work experience, education, licenses, certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
Now ensure no extra sections.
Now output HTML fragment
for prose. We need to decide which content goes where. About the role: Could be the first paragraph summarizing role: "Under the direction of the Manager of Behavioral Health Network and Contracting, the Behavioral Health Account Manager assists in the development and maintenance of a Behavioral Health provider network that ensures Healthfirst members have superior access to the highest quality, cost-effective providers of Behavioral Healthcare services in compliance with Medicare, Medicaid, the Health and Recovery Plan (HARP) and others. The individual must possess experience working closely with providers or in a managed care setting. The ideal candidate will have experience in Behavioral Health network development, provider recruitment, provider education and contract negotiations. This position works closely cross-functionally with Network Management, Credentialing and Business Analytics to maximize operational and financial efficiency. Medicaid experience preferred. Extensive field work is required. The Behavioral Health Account Manager will represent and advance Healthfirst’s interests in the Behavioral Health provider market as the preeminent plan in the NYC marketplace through first-rate customer service and execution of provider engagement strategies. This position will advance Healthfirst in the Behavioral Health provider market." That's a lot; we can keep as prose. Responsibilities: list of duties: "Assists in the development and recruitment of the Behavioral Health network based on department needs and Healthfirst priorities. Negotiates and executes Single Patient Agreement for Out of Network providers in order to determine the provider’s payment arrangement. Individual must be familiar with or have the ability to learn contracting and reimbursement methodologies for inpatient and outpatient services. Conducts comprehensive provider network training onsite, through webinars, or at off-site provider locations that will support network providers in gaining appropriate knowledge, skills and technical expertise ultimately ensuring providers understand and are compliant with managed care requirements. Organizes provider training materials and education of BH providers ensuring that providers understand any new services or initiatives including the following: Behavioral Health- Home and Community Based Services (HCBS), Recovery Coordination Agencies, Children’s Family Treatment and Support Services. Responsible for the creation of various Microsoft PowerPoint presentations and other documents. Educate providers on Healthfirst policies and procedures such as billing, authorization, utilization of Healthfirst’s provider portal, claims inquiries, etc. Conducts initial provider orientation. This orientation is also available periodically via webinar. Topics will include: expanded array of benefits, Health Homes, Claims, Authorizations, Cultural Competency, Evidence Based Practices, Utilization Management, HCBS eligibility/assessment and the secure provider portal. Assists in obtaining credentialing documentation for new providers, distributes and collects executed contracts, distributes provider communication and provides network maintenance to ensure access and availability standards such as travel time/distance to BH Providers, are adequate and compliant. Reviews provider issues and performs root cause analysis by operating in an analytical framework, resolving provider’s issues and ensuring timely and positive outcomes. Appropriately escalates critical and other concerns that the Provider may have in order to resolve issues accordingly. Provides internal support for the resolution of operational problems as they pertain to the contracting process, claims payments and/or BH provider contracts. Participates in meetings by providing analysis, feedback and recommendations that foster a successful relationship between Healthfirst, external agencies and essential providers. Monitors and conducts regular audits as needed of contracted behavioral networks to ensure that accurate information such as demographics, payment and fee schedules are loaded into Healthfirst’s systems appropriately. Resolves configuration issues when identified to prevent further claim denials." We can break into bullet list. Requirements: Minimum Qualifications: "High School Degree/GED, Experience and understanding of health care reimbursement methodologies, Knowledge of Medicare and Medicaid products, Must have either: Behavioral Health, network development, provider relations or provider education experience, Ability to travel to various NY boroughs as needed (car not required), Experience with Microsoft Outlook or similar calendar management, Demonstrated ability to multi-task, prioritize and use good judgement in a fast-paced environment." Qualifications: Preferred Qualifications: "Bachelor’s Degree, Previous experience in a managed care environment working closely with providers, Ability to take initiative and work independently in a dynamic environment, Strong customer-centric and analytical skills, Excellent oral and written communication skills, Strong presentation and problem-solving skills, Valid driver's license and insured automobile, Familiar with root cause analysis" Skills: Could combine some skills from preferred qualifications? But we already have qualifications sections. Maybe we can treat "Skills" as separate for things like "Strong presentation and problem-solving skills, Strong customer-centric and analytical skills, Excellent oral and written communication skills, Ability to multi-task, prioritize, use good judgement". However we already have those in qualifications. To avoid duplication, maybe we omit Skills section if content overlaps. But instructions: Prefer a few substantive sections over many thin ones. We could combine Requirements and Qualifications into one? But they ask to use headings for those specific names if content exists. We have both minimum and preferred qualifications; we could put them under Requirements (minimum) and Qualifications (preferred). Skills maybe not needed. Benefits: "In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live." Pay: "Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $68,900 - $99,620; All Other Locations (within approved locations): $61,300 - $91,120. As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision." We should not include the asterisk note? It's part of posting; we can keep. Schedule: none, omit. Now produce HTML fragment. We need to wrap each section:
About the role
...
etc. For lists:- ...
Under the direction of the Manager of Behavioral Health Network and Contracting, the Behavioral Health Account Manager assists in the development and maintenance of a Behavioral Health provider network that ensures Healthfirst members have superior access to the highest quality, cost‑effective providers of Behavioral Healthcare services in compliance with Medicare, Medicaid, the Health and Recovery Plan (HARP) and others. The individual must possess experience working closely with providers or in a managed care setting. The ideal candidate will have experience in Behavioral Health network development, provider recruitment, provider education and contract negotiations. This position works closely cross‑functionally with Network Management, Credentialing and Business Analytics to maximize operational and financial efficiency. Medicaid experience preferred. Extensive field work is required. The Behavioral Health Account Manager will represent and advance Healthfirst’s interests in the Behavioral Health provider market as the preeminent plan in the NYC marketplace through first‑rate customer service and execution of provider engagement strategies. This position will advance Healthfirst in the Behavioral Health provider market.
Now Responsibilities list: each duty aswith the hiring range details. Let's craft:
Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $68,900 – $99,620; All Other Locations (within approved locations): $61,300 – $91,120. Salary and related elements of compensation are contingent upon work experience, education, licenses, certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
Now ensure no extra sections. Now output HTML fragment