Payor Contracting Manager
Pay Range: $75-$90K
Position Overview
Behavior Frontiers is an industry leader in ABA (Applied Behavior Analysis) treatment for autism and other special needs. We are seeking an experience, highly organized, detail-oriented Payor Contracting Manager to support the Vice President of Contracting and Public Policy in managing payor contracting activities including researching and initiating new contracts, payor network maintenance, agency enrollments, site applications and location adds for our rapidly growing multi-state Applied Behavior Analysis (ABA) services agency. This role is responsible for coordinating time-sensitive enrollment and contracting projects, maintaining accurate location and payor records, and helping ensure that new and existing agency locations are properly affiliated with the relevant commercial and Medicaid plans as they come online.
The ideal candidate has 2-3 years’ experience in ABA contracting with an agency or on the payor side, has excellent written and verbal communication skills, is deadline sensitive, can manage multiple projects concurrently, and can pivot quickly between priorities without sacrificing accuracy or follow-through. This position works closely with payors and internal clinical, operations, finance, revenue cycle, credentialing, and compliance teams.
Key Responsibilities
· Support the Vice President of Contracting and Public Policy with agency enrollments, revalidations, contracting projects, and related tasks.
· Coordinate initial and ongoing enrollments with commercial payors, Medicaid programs, managed care organizations, and other private and government payors.
· Prepare, organize, and submit required documentation as required
· Collaborate with revenue cycle, operations and leadership teams to obtain information needed for enrollments, contracting, service expansion, and compliance submissions.
· Ensure accuracy of all documents, forms and related information to avoid delays and denials
· Maintain accurate location rosters across payors, internal systems and trackers
· Submit and track location “adds” with commercial and Medicaid plans as new Behavior Frontiers locations come online or existing locations change.
· Monitor application, contract, revalidation, location-add and other submissions’ status; follow up proactively to avoid delays and to address issues in a timely and efficient manner
· Share approvals, effective dates and related details with internal stakeholders
· Maintain organized contracting files, correspondence, contact information, contract records, and audit-ready supporting documentation.
· Serve as a professional point of contact with payor representatives and respond promptly to requests for information or additional documentation.
· Coordinate with Revenue Cycle and Finance to confirm fee schedules, reimbursement terms, effective dates, CPT codes and other details to maintain payor profiles in Salesforce
· Manage confidential and sensitive business information with discretion.
· Perform other duties as assigned
Required Qualifications
· 2-3 years of experience in a contracting-related role, preferably in ABA, behavioral health, healthcare, managed care, provider enrollment, credentialing, or payor relations on either the agency or Payor side
· Bachelor’s degree in healthcare administration, Business Administration, Finance, Public Health, or a related field preferred; equivalent relevant experience may be considered.
· Experience working with commercial insurance plans, Medicaid programs, managed care organizations, or other healthcare payors.
· Excellent verbal and written communication skills, including the ability to prepare clear, professional correspondence and explain complex requirements.
· Exceptional time-management and organizational skills.
· Demonstrated ability to manage multiple projects concurrently, pivot quickly from one priority to another, and maintain accuracy in a fast-paced environment.
· Strong writing, proofreading, documentation, analytical, and problem-solving skills.
· Clear understanding of the significance of deadlines and the operational, financial, and compliance consequences of missed submissions.
· Meticulous attention to detail and a strong commitment to complete, accurate, and timely work.
· Ability to work independently, exercise sound judgment, take ownership of assignments, and follow through to resolution.
· Proficiency with Microsoft Word, Excel, Outlook, Teams and Salesforce.
Preferred Qualifications
· Experience in the ABA or autism services field.
· Experience supporting a multi-state healthcare or behavioral health provider organization.
· Familiarity with commercial and Medicaid enrollment, revalidation, roster maintenance, provider portals, location additions, network participation, and payor directories.
· Knowledge of healthcare contracting terminology, reimbursement arrangements, fee schedules, CPT codes, and credentialing requirements.
· Experience maintaining detailed project trackers, status reports and contract records.
· Core Competencies
· Deadline ownership and accountability
· Follow-through
· Attention to detail and quality control
· Project and priority management
· Clear, concise, and professional communication
· Strong writing and documentation skills
· Adaptability and rapid prioritization
· Cross-functional collaboration
· Critical thinking and problem-solving
· Confidentiality and professional judgment