[Hiring] Manager of Payer Relations, Contracting, & Credentialing @Northpoint Recovery Holdings, LLC

Role Description

As a key member of the Northpoint team, reporting to the Executive Vice President of Revenue Cycle Management, the Manager of Payer Relations, Contracting & Credentialing is responsible for advancing Northpoint’s payer strategy through effective payer relationship management, contract negotiation and performance, network development, and credentialing oversight across the organization’s markets. This position serves as a key organizational liaison with commercial and government payers and is responsible for:

• Developing and maintaining productive payer relationships.
• Identifying opportunities to strengthen network participation and reimbursement.
• Resolving payer-related barriers.
• Supporting Northpoint’s continued expansion into existing and new markets.

The Manager leads the full lifecycle of payer contracting, including:

• Contract evaluation.
• Negotiation.
• Rate strategy.
• Amendments.
• Reimbursement terms.
• Operational implementation of contractual requirements.

This position partners closely with various departments to evaluate payer performance, identify emerging risks and opportunities, and ensure payer strategies support patient access, revenue integrity, and organizational growth.

The position also maintains leadership oversight of Northpoint’s credentialing, recredentialing, enrollment, licensing, and related regulatory processes, ensuring facilities and providers remain appropriately credentialed and compliant with payer, state, federal, CAQH, Medicare, and Medicaid requirements.

Qualifications

• Bachelor’s degree in business administration, health management, or commensurate experience required.
• Minimum of five (5) years of experience in managed care contracting and provider credentialing.
• Minimum of three (3) years of hospital and/or payer negotiation and payer analysis experience.
• Knowledge of fee-for-service and/or fee-for-value reimbursement methods, delegated credentialing workflows, and working knowledge of all major payers.
• Strong at synthesizing information; easily distill easy-to-understand takeaways and next steps, diagnose problems, see patterns, and come up with targeted solutions.
• Self-Starter; organize processes, improve workflows that already exist, and continuously strive for more efficiency.
• Impeccable attention to detail; able to catch areas of opportunity in data or workflows quickly and document processes in a concise but thorough manner.
• Must work well under pressure, able to focus on multiple priorities while maintaining focus, attention to detail and connecting all the dots.
• Proficiency with Microsoft Office Suite.

Requirements

• Knowledge of behavioral health care HCPCS/CPT coding.
• Business acumen and strong financial skills.
• Able to maintain confidentiality of sensitive information.
• Excellent communication skills: ability to communicate clearly and concisely, verbally and in writing.
• Strong interpersonal skills to handle sensitive situations and confidential information.
• Social ease and a demonstrated ability to build relationships with a variety of different people and personality types.
• Ability to perform several tasks concurrently with ease and professionalism.
• Ability to effectively prioritize workload in a fast-paced environment.

Benefits

• Subsidized Health Insurance Coverage for Employee, Spouse, & Dependent(s).
• 100% Employer Paid Basic Life Insurance equal to 1x annual salary, up to $100,000.
• 100% Employer Paid Employee Assistance Program.
• Voluntary Dental, Vision, Short-Term Disability, Supplemental Life & AD&D, Critical Illness, Accident, and Hospital Indemnity Insurance.
• Pre-tax Savings Accounts for all IRS-allowable medical and dependent care expenses.
• Generous Paid Time Off plan.
• Employee Referral Bonuses.
• 401K Retirement Plan & Employer Match.