Manager of Payer Strategy and Revenue Intelligence

Palm Beach Gardens, FL - USA

Monthly Salary: $ 65000 - 75000

Experience Required: 1-3years

Posted on: 4 hours ago

Vacancies: 1 Vacancy

Job Summary

This is a remote position.

Atlantic Health Strategies is seeking a Manager of Payer Strategy and Revenue Intelligence for a full-time individual-contributor role focused on behavioral health and substance use disorder services. This is a hands-on position not a managerial or supervisory role and is best suited for someone who enjoys doing the work at the intersection of payer policy reimbursement analytics and billing compliance.

The role is intentionally split: approximately 50 percent payer research reporting and business intelligence and 50 percent direct execution of payer contracting support credentialing and billing compliance review. The purpose of the role is to ensure that payer strategy reimbursement assumptions and revenue models used by Atlantic Health Strategies and its clients are defensible compliant and grounded in real payer rules.

This position reports directly to senior leadership and supports behavioral health providers across Medicaid-heavy and mixed-payer markets including states such as Tennessee Missouri Ohio and similar regulatory environments. Compensation for this role is $65000$75000 annually commensurate with experience. The role is full-time and fully remote.

Core responsibilities

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.
This role is designed for someone who understands how behavioral health is actually reimbursed in the real world not how it is supposed to work on paper. It rewards rigor curiosity and operational fluency rather than title or headcount

Benefits

Compensation for this role is $65000$75000 annually commensurate with experience.
The role is full-time and fully remote.

Required Skills:

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 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. This role is designed for someone who understands how behavioral health is actually reimbursed in the real world not how it is supposed to work on paper. It rewards rigor curiosity and operational fluency rather than title or headcount

Required Education:

This role is designed for someone who understands how behavioral health is actually reimbursed in the real world not how it is supposed to work on paper. It rewards rigor curiosity and operational fluency rather than title or headcount.

This is a remote position.Atlantic Health Strategies is seeking a Manager of Payer Strategy and Revenue Intelligence for a full-time individual-contributor role focused on behavioral health and substance use disorder services. This is a hands-on position not a managerial or supervisory role and i...

This is a remote position.

Core responsibilities

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.
This role is designed for someone who understands how behavioral health is actually reimbursed in the real world not how it is supposed to work on paper. It rewards rigor curiosity and operational fluency rather than title or headcount