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Full Spectrum Behavioral Health Support
Manager – Payer Strategy, Revenue Intelligence
Location
Ohio + 2 moreAll locations: Ohio | Missouri | Tennessee
Posted
148 days ago
Salary
$65K - $75K / year
Seniority
Junior
Job Description
Manager – Payer Strategy, Revenue Intelligence
Atlantic Health Strategies™
• Execute hands-on payer contracting and credentialing support for behavioral health and substance use disorder providers, including research, sequencing, payer selection, and application strategy by state and level of care. • Conduct detailed billing compliance and reimbursement reviews to validate that services, codes, modifiers, units, and rates align with behavioral health payer rules, Medicaid state plans, and managed care organization requirements. • Serve as an internal subject-matter expert on behavioral health reimbursement, including PHP, IOP, OP, MAT, and related services across Medicaid and commercial payers. • Perform deep payer and regulatory research, including Medicaid state plans, managed care contracts, utilization guidelines, and commercial payer manuals, translating findings into clear internal guidance and client-ready analysis. • Develop payer-focused reports, reimbursement analyses, and BI outputs that reflect actual payer methodologies rather than assumed or modeled rates. • Build and maintain internal payer intelligence tools, including reimbursement matrices, payer summaries, credentialing trackers, and contracting reference materials specific to behavioral health. • Support payer relations and audit preparedness by developing documentation, financial analysis, and regulatory interpretation to support payer inquiries, audits, and contract discussions. • Partner with leadership on payer mix strategy, revenue integrity risk identification, and market entry analysis for behavioral health programs.
Job Requirements
- Demonstrated experience in behavioral health payer contracting, credentialing, reimbursement analysis, billing compliance, or payer policy research.
- Strong working knowledge of behavioral health coding, reimbursement structures, and level-of-care distinctions, particularly within Medicaid managed care environments.
- Exceptional independent research skills, with the ability to interpret complex payer and regulatory documentation without reliance on templates or third-party summaries.
- Analytical judgment is sufficient to identify reimbursement risk, challenge unsupported revenue assumptions, and validate billing and payer data.
- Clear written and verbal communication skills, particularly when translating complex behavioral health payer rules for leadership, clients, and internal teams.
- Comfort operating in a consulting or advisory environment with shifting priorities, high accountability, and an expectation of precision.
Benefits
- Compensation for this role is $65,000–$75,000 annually, commensurate with experience.
- The role is full-time and fully remote.
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