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Cenikor Foundation is a non profit organization and one of the largest substance use treatment centers in the nation. We are currently seeking a Full Time Payor Relations Manager at our Houston, Texas, Facility Support Center. Cenikor’s Value Proposition – What’s In It for You?:
PURPOSE in your work – service to others, giving back to your community, helping to save lives, being fulfilled at work.
COMPETITIVE PAY, BENEFITS, PAID TIME OFF, $2k - $4k TUITION REIMBURSEMENT, up to 10% 401K and BONUSES – we hire and reward high performers.
STABILITY and GROWTH – more than 55 years in business – our strong financial processes support our drive to serve more people and ensure stability for our team members.
CONTINUOUS LEARNING and PROFESSIONAL DEVELOPMENT – we are committed to developing our leaders in their desired career path and promoting from within. We have Cenikor Career Pathways Program that you can join after 90 days of employment. We also have an annual leadership development program with assigned mentors to help you achieve your professional goals.
The work we do isn’t easy. If you like to work hard, to serve others and to have FUN with your team while achieving goals, Cenikor will be the right place for you!
The Job Summary and Description – What’s expected of you?:
The Payer Network Development Manager, you will be responsible for growing our direct strategic relationships with insurance payers in order to unlock greater coverage for our users and overall growth of the business.
ESSENTIAL FUNCTIONS:
Build, develop and maintain payer analytics capability to benchmark utilization and reimbursement levels across the growing Behavioral Health and Substance Abuse network.
Evaluate new payers/networks and their fees for participation and present to the Payors including Medicaid and Commercial.
Thoroughly analyze and review rates and utilization and present to Senior leadership.
Analyze fee schedules by specialty and code relative to historical company utilization and industry standards.
Track contracts and anniversary dates to ensure annual rates are implemented correctly and on time.
Quantify rate impacts during negotiations and monitor ongoing utilization and expected fee changes.
Assist in developing and maintaining appropriate policies, procedures, and controls for contracts and payer contracting activity.
Build large data models to forecast and monitor payer rates by code.
Build and deepen relationships with key contacts with payers through ongoing communications; keep a record of conversations with payers, schedule periodic phone calls and update payer contact lists.
Develop presentations to report on progress and results.
Uphold the core principles of Cenikor’s culture and create a positive working environment for all team members. Be able to effectively communicate the core principles of Cenikor’s culture to candidates during interview process.
Perform additional duties as assigned and consistent with the non-exempt functions as defined in this job description.
QUALIFICATIONS FOR THE POSITION:
Skills, Knowledge and Abilities:
You have 8+ years of experience in healthcare and insurance industries within a business development, partnerships, or operations
You have a deep understanding of the insurance payer landscape
Ability to build relationships with all types of insurance payers, from big commercial payers to smaller local payers and managed Medicaid
You excel at building relationships with key decision makers and have a proven track record of success in developing payer segment strategies and securing in-network access across different payer types
You are strategic partner to both internal and external stakeholders, with the ability to create win-win relationships that lead to positive business outcomes
You are passionate about the healthcare industry and have a proven track record of success in insurance payer access
You thrive in an environment that values collaboration over individual achievement
Ability to consistently uphold the Core Principles of Cenikor’s Culture:
Demonstrate mission of service to our clients
Positive, respectful communication with both staff and clients
Demonstrate self-motivation and perseverance to achieve goals
Role model appropriate, professional behaviors including appropriate client boundaries
Work effectively as part of a team, helping to set up others for success
Must possess excellent communication and presentation skills including persuasiveness, assertiveness, initiative and sensitivity with both internal and external payor executive leadership.
Education:
High School Diploma or GED
Experience:
Minimum two years of Payor Relations experience required; preferably in behavioral health or Substance abuse.
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