Remote
4 days ago
Credentialing, Contracts and Payor Specialist
**Mentor South Bay** , provides Early Intervention, Applied Behavioral Analysis (ABA), Behavioral Health and Mental Health Outpatient services across Massachusetts and Connecticut. For over 35 years, we’ve provided a collaborative, team-based approach dedicated to helping children, adults, and families reach their fullest potential. If you are passionate about making a difference in the lives of individuals and families, join our mission-driven team and experience a career well lived. The Credentialing Contracts and Payor Specialist is a remote position responsible for identifying and securing public and private insurance contracts; reviews and organizes existing contracts. The Specialist assists with the development of potential relationships with strategic partners and creates measurable business results for various markets. **Prior healthcare credentialing experience a must.** **Contracting and Credentialing** + Works in partnership with Program Directors and Director of Contracts and Payor Engagement to ensure consistency and secure public and private insurance contracts + Analyzes and monitors financial aspects of existing contracts and maintains original documentation of all contracts + Identifies, contacts, and creates relationships with potential payors that result in new contracts and increased funding possibilities for program participants + Conducts rate and contract negotiations + Describes CFS programs to potential contract sources + Communicates with state directors, and state operating/marketing staff regarding contract specifics. Ensures commitments to participants, family, referral sources and payors are met + Completes contract related credentialing and enrollment application requirements + Maintains database of licenses, accreditation forms, financial and organizational information for the purpose of efficient and timely enrollment application + Oversees Single Case Agreement process within the Admissions Teams. May take lead in difficult single case negotiation + Multi-state experience a plus **Other Duties:** + Communicates contract executions and requirements to all internal departments + Facilitates resolution of contract related issues with billing and collections team + Performs other related duties and activities as required **Qualifications:** + Bachelor’s degree in Rehabilitation Administration, Business Administration or related field preferred + Three to five years’ experience with contracts, managed care, and health insurance related industry preferred + A reliable, responsible attitude and a compassionate approach + A commitment to quality in everything you do **Why Join Us?** + Full time position + Full compensation/benefits package for employees working 32+ hours/week + 401(k) with company match + Paid time off and holiday pay + Rewarding work, impacting the lives of those you serve, working alongside a great team of coworkers + Enjoy job security with nationwide career development and advancement opportunities + Compensation begins at $50,000 based on experience **We have meaningful work for you – come join our team – Apply Today!** **Join Our Team** If you are passionate about making a difference in the lives of individuals and families, we encourage you to join Mentor South Bay’s mission of helping everyone live a full and happy life. Apply today and start your journey toward a rewarding career well-lived. _As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law._
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