Behavioral Health Account Manager

Health First - New York, NY

Full-time

New York, NY

Ambulatory Health Care Services

About the position

The Behavioral Health Account Manager plays a crucial role in developing and managing the Behavioral Health network for Healthfirst. This position involves negotiating agreements with out-of-network providers, conducting training sessions for network providers, and ensuring compliance with managed care requirements. The manager will also assist in credentialing new providers and resolving operational issues related to provider contracts and claims payments.

Responsibilities

• Assist in the development and recruitment of the Behavioral Health network based on department needs and Healthfirst priorities.
• Negotiate and execute Single Patient Agreements for Out of Network providers to determine payment arrangements.
• Conduct comprehensive provider network training onsite, through webinars, or at off-site locations to ensure providers understand managed care requirements.
• Organize provider training materials and educate BH providers on new services and initiatives.
• Conduct initial provider orientation covering various topics related to Healthfirst policies and procedures.
• Assist in obtaining credentialing documentation for new providers and maintain network access standards.
• Review provider issues, perform root cause analysis, and resolve issues in a timely manner.
• Participate in meetings providing analysis, feedback, and recommendations to foster successful relationships with providers.
• Monitor and conduct regular audits of contracted behavioral networks to ensure accurate information is maintained.

Requirements

• High School Degree/GED
• Experience and understanding of health care reimbursement methodologies
• Knowledge of Medicare and Medicaid products
• Experience in Behavioral Health, network development, provider relations, or provider education
• Ability to travel to various NY boroughs as needed
• Experience with Microsoft Outlook or similar calendar management
• Demonstrated ability to multi-task, prioritize, and use good judgement in a fast-paced environment.

Nice-to-haves

• Bachelors Degree
• Previous experience in a managed care environment working closely with providers
• Ability to take initiative and work independently in a dynamic environment
• Strong customer-centric and analytical skills
• Excellent oral and written communication skills
• Strong presentation and problem-solving skills
• Valid driver's license and insured automobile
• Familiar with root cause analysis.