BCBS Behavioral Health Consultant

We are a growing outpatient behavioral health group practice in New York seeking an experienced managed care contracting consultant to assist with negotiating reimbursement rate increases specifically with Blue Cross Blue Shield / Elevance for outpatient psychotherapy services. This project is focused specifically on improving reimbursement rates for the following CPT codes: - 90791 - 90832 - 90834 - 90837 - 90847 We are looking for someone with DIRECT experience in: - behavioral health payer contracting - commercial insurance reimbursement negotiations - provider contracting or provider relations - BCBS / Elevance negotiation experience - managed care strategy for outpatient mental health practices Strong preference will be given to candidates who previously worked: - for commercial insurance payers - in provider contracting - in provider relations - in behavioral health network management This is NOT a medical billing, credentialing, or revenue cycle management role. Initial Scope (Milestone 1 – Fixed Price): - review current BCBS reimbursement rates - evaluate negotiation opportunities - identify leverage points and strategy - prepare negotiation recommendations and escalation approach - assist with drafting negotiation language if appropriate Budget for initial strategy phase: - approximately $300 fixed price Potential Phase 2: If there is a successful executed reimbursement increase, we are open to a success-based compensation structure tied to the negotiated increase. Success will only be considered achieved if: - a written fee schedule increase or contract amendment is executed - the increase applies to the agreed CPT codes above - the increase applies to the group practice - the increase is permanent and not temporary/promotional