Manager – Payer Strategy, Revenue Intelligence

Job Description: • 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. 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. Apply tot his job