Behavioral Health Insurance Contracting Specialist (Medicaid and Commercial Payers)
We are a growing behavioral health organization launching an Intensive Outpatient Program (IOP) and Partial Hospitalization Program (PHP). We are seeking an experienced insurance credentialing and payer contracting specialist who can help our organization become in network with Medicaid and commercial insurance companies.
This role requires someone who can actively manage the process, follow up with payers, and push applications through until approval. Our goal is to secure in network status as quickly as possible with key payers.
Key Responsibilities:
- submit and manage provider credentialing applications
- submit and track facility enrollment with Medicaid
- contract with commercial payers (Harvard Pilgrim, Optum, etc.)
- communicate with payer contracting departments
- follow up weekly with payers until in network achieved
- ensure proper taxonomy codes and facility enrollment requirements
- track and report status of all applications
- provide all contracts to operations director
Target Insurance Panels:
- Medicaid
- NH Healthy Families, Amerihealth, Wellsense
- Harvard Pilgrim
- Optum/Carelon behavioral health networks
Requirements:
- proven experience with behavioral health credentialing
- experience credentialing IOP, PHP, or addiction treatment programs preferred
- knowledge of Medicaid enrollment and facility credentialing
- experience working with CAQH, Availity, and PECOS
- strong follow up and communication with payer contracting departments
Deliverables:
- successful submission of all credentialing applications
- active follow up with payers until approval
- weekly status reports or progress
- documentation of all payer communications
About Us:
We operate structured recovery housing and are expanding clinical services to provide high quality outpatient behavioral health treatment. Our mission is to help individuals build a strong foundation in recovery and access the care they need.
When Applying, Please Include:
- examples of programs you have credentialed
- payers you have successfully contracted with
- typical timeline you achieve for Medicaid and commercial enrollment
Apply Now
Apply Now
This role requires someone who can actively manage the process, follow up with payers, and push applications through until approval. Our goal is to secure in network status as quickly as possible with key payers.
Key Responsibilities:
- submit and manage provider credentialing applications
- submit and track facility enrollment with Medicaid
- contract with commercial payers (Harvard Pilgrim, Optum, etc.)
- communicate with payer contracting departments
- follow up weekly with payers until in network achieved
- ensure proper taxonomy codes and facility enrollment requirements
- track and report status of all applications
- provide all contracts to operations director
Target Insurance Panels:
- Medicaid
- NH Healthy Families, Amerihealth, Wellsense
- Harvard Pilgrim
- Optum/Carelon behavioral health networks
Requirements:
- proven experience with behavioral health credentialing
- experience credentialing IOP, PHP, or addiction treatment programs preferred
- knowledge of Medicaid enrollment and facility credentialing
- experience working with CAQH, Availity, and PECOS
- strong follow up and communication with payer contracting departments
Deliverables:
- successful submission of all credentialing applications
- active follow up with payers until approval
- weekly status reports or progress
- documentation of all payer communications
About Us:
We operate structured recovery housing and are expanding clinical services to provide high quality outpatient behavioral health treatment. Our mission is to help individuals build a strong foundation in recovery and access the care they need.
When Applying, Please Include:
- examples of programs you have credentialed
- payers you have successfully contracted with
- typical timeline you achieve for Medicaid and commercial enrollment
Apply Now
Apply Now