Overview

Since opening our doors in 1902, CHS became a part of Florida's history. 

CHS has been committed to growing and evolving to provide the right services and solutions to address the needs of children and families throughout the changing times. Every day, our team works with parents and kids to empower them and encourage them. With innovative technology solutions and a dedicated, experienced team throughout the state, we’re changing the face of foster care and positively impacting children and families’ lives for generations to come.

Join our team to continue to do good and create history serving Florida's children and families!

The Provider Relations Manager  serves as the primary contact for behavioral health funders and oversee contracts, communication, and coordination between CHS and funders. Overall, the Provider Relations Manager contributes to the CHS high performance culture by exhibiting our values and providing quality results that position CHS as the leader in delivering proactive behavioral health, case management, community and early childhood solutions for children and families. 

WHY JOIN CHS?

• Uplifting mission-driven work culture
• Make an impact in your community and become a part of Florida's history!
• Growth and professional development opportunities
• Great benefits package, including generous paid time off and holidays

Primary Job Functions

1. Serve as the primary contact and liaison between behavioral health payer and CHS.

• Review, communicate and educate CHS staff on all payer changes, updates and information throughout all behavioral health programs and department areas.
• Maintain Behavioral Health contracts, fee schedules and payer handbooks.
• Coordinate the set up and implementation of new or revised contracts, fee schedules and payer changes.
• Assist with contract, service array and fee-schedule negotiations.
• Negotiate or assist with appeals, settlements and timely payments resolutions as assigned.
• Set up and maintain the Electronic Medical Record for payer and contract information.
• Supervise and maintain the credentialing activities for all behavioral health staff including set up and maintenance in the electronic medical record.
• Supervise and maintain credentialing for CHS behavioral health practice locations including set up and maintenance in the electronic medical record system.
• Monitor and evaluate accounts receivable trends to identify payer issues.
• Participate or lead, as assigned, behavioral health team projects.

2. Contribute to a positive, engaging work environment.

• Develop a strong knowledge base and stay current on job-related issues and trends.
• Participate actively in departmental meetings, training and education, as well as the quality process.
• Comply with CHS’s code of conduct, policies, procedures and other obligations.
• Assist with training other team members and providing back up when necessary.
• Pick up projects on the fly; perform other duties as assigned from time to time.
• Demonstrate the CHS Common Bond values in the performance of all job duties.

Job Qualifications

Education, Licenses & Certifications:

• Bachelor's Degree in Accounting, Finance, Business, Health Care or Human Services Administration or related field from an accredited university, required.
• Florida Driver’s License within 30 days from hire with daily access to a reliable and insured vehicle, required.

Experience:

• Three years progressively responsible experience working in the health or behavioral health care industry
• Experience managing contracts and payer relationships, required.
• Experience with Electronic Health Record Systems, required.
• Experience with MyEvolv (NetSmart) Electronic Medical Record, preferred.
• Experience with insurance, Medicaid, and/or Medicaid claims processing, preferred.
• Experience as a provider relations or contract representative in behavioral health or similar field, preferred.

Competencies

Knowledge of:

• Florida Medicaid behavioral health requirements
• Accounting practices and reporting related to billing and collections (accounts receivable, aging)
• Billing and collection processes, payment posting
• CPT, ICD-10 insurance claim forms including electronic submission files

Skills and Proficiency in:

• Planning, project management, organization and time management
• Oral and written communication, including presentation and platform
• Collaboration, teamwork, consulting, facilitation, coaching and mentoring
• Computer systems and MS Office, including Word, Excel and Outlook
• Analytical skills

Ability to:

• Work in a deadline driven environment with multiple priorities Perform at a high level of autonomy, with general supervision.
• Create and analyze data reports routinely.
• Manage and lead project teams.
• Maintain electronic health record maintenance tasks related to payer and credentialing activities.
• Work independently and to collaborate with teams of individuals in diverse settings.
• Perform under strong demands in fast-paced, diverse, sometimes ambiguous environments.
• Commit to providing high customer satisfaction with positive service delivery results.
• Meet critical deadlines, while maintaining attention to detail, accuracy and quality.
• Handle highly stressful, sensitive situations; maintain confidentiality and professional boundaries.
• Demonstrate the behaviors of our CHS Common Bond Values.
• Be energetic, passionate and adaptable with a deep commitment to social service, empathy for children and families and a positive approach to embracing and managing change

Schedule Expectations

The incumbent will work a standard scheduled week, which may include weekends, holidays and evenings. The ability to work flexible hours is required to meet business needs. If working remotely, incumbent will be required to be available by telephone and email during specified hours. Travel will be on an as-needed basis to conduct business-related activities. In the event of a declared disaster or emergency, this Business Operations Continuity position will be required to carry out assigned duties to provide CHS with the capability and capacity to operate its business functions.

 Together, good can be done.