Loyal Source Government Services’ Behavioral Health Division is looking for an innovative team member to serve as the Credentialing/Contract Specialist at a new behavioral health facility located in Orlando, Florida; offering face-to-face services in the Orlando surrounding area and telemental health capabilities throughout the state of Florida and beyond.

Candidate must have experience with fee-for-service and value-based contracting, enrollment and credentialing, payor optimization, and outsourced contracting support; must be motivated and driven; and will oversee and implement day-to-day contract insurance payor operations the Loyal Source behavioral health facility. Specific responsibilities will include:

Developing insurance company contracting strategy based on Loyal Source’s competitive position, specialty dynamics, personnel, analysis of local and regional historical contracts and reimbursements, growth trajectory, partner relationships, and Loyal Source experience.
Identifying and prioritizing payor organization targets.
Credentialing providers, to include document collection, application submission and status tracking, and ongoing credentialing management to ensure compliance.
Contacting appropriate personnel at each payor organization with the objective of securing new in-network contract offers or re-negotiating legacy agreements to maximize reimbursement rates and optimize contract terms for long-term value.
Escalating to more-senior levels as is prudent to obtain contract offers and/or more-favorable reimbursement rates and terms.
Providing analysis surrounding managed care contract offers and advise on responses. Assisting with selection and implementation of electronic health record system, including cost-benefit analysis, vendor recommendations, and business model budgeting/ projection modelling.

Candidate will work with a small team of behavioral health clinicians providing veteran, first responder, children, and family care. Candidate should apply expertise to develop prioritized payor contract targets, navigate the labyrinth of payor representatives, strengthen the clinic (s) payor portfolio to yield more patients and higher reimbursement, provide real-time status updates, regularly track progress, and update the Loyal Source payor strategy, as needed.

Candidate should ideally, have an existing relationship with a payor(s).

Loyal Source is an Orlando-based workforce solutions provider dedicated to delivering elite services worldwide. With a focus in government healthcare, technical and support services, engineering, and travel healthcare, Loyal Source provides exceptional custom solutions to both private enterprise and government agencies. Loyal Source is a military friendly employers and proud partner of the Military Spouse Employment Partnership program.

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Loyal Source does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor

This contractor and subcontractor abides by the requirements of41 CFR 60-1.4(a),60-300.5(a)and60-741.5(a). These regulations prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity or national origin. Moreover, these regulations require that covered prime contractors and subcontractors take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.Tracking

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