Health Plan Contract Manager

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.

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. 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.

About the Role

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. CBI is the premier 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.

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

Culture

CBI offers a competitive compensation package and is committed to fostering a positive work environment. The organization values its employees and provides various benefits such as a generous PTO plan, wellness programs, and opportunities for professional development. CBI is recognized as one of the top ten healthiest mid-size employers in the Valley by The Phoenix Business Journal. The company is dedicated to maintaining the dignity of human life and believes in recovery for all patients.