Behavioral Health Vendor Relations Manager serving as liaison and managing vendor relationships for Fallon Health. Focused on operational excellence and compliance in behavioral healthcare.
Responsibilities
Serve as the primary liaison between Fallon Health and its contracted behavioral health vendor
Ensure seamless contract execution, operational excellence, and financial oversight across all lines of business
Drive strategic partnerships, lead cross-functional initiatives, and promote behavioral health integration to improve member outcomes and vendor performance
Lead weekly vendor account meetings to address operational needs and resolve issues
Manage behavioral health provider contracts and maintain accurate documentation
Develop and maintain vendor scorecards and performance metrics
Identify and implement process improvements for vendor management
Monitor and verify that the vendor consistently meets all compliance, regulatory, and contractual obligations as outlined in agreements
Collaborate with the vendor and organizational leadership to proactively identify areas of concern or non-compliance, and address these through structured discussions during weekly account meetings
Serve as department lead on cross-functional teams and subcommittees
Coordinate with internal departments (Care Services, Claims, Credentialing, IT, Finance)
Requirements
Bachelor's degree required
Master's degree in Healthcare Administration, MBA, MPP, MPH or similar preferred, but not required
License or Certification in behavioral health (e.g., CADC), or as a behavioral health professional (e.g., LMHC, LCSW, LICSW, LADC etc.) is required
Valid Massachusetts Driver’s License
Minimum 3 years in a managerial role overseeing programs, vendors, or operations, preferably in managed healthcare or public sector programs
Knowledge of Medicare and Medicaid reimbursement, behavioral health coding and billing, and state contracts
Familiarity with the continuum of care for SUD and BH services in Massachusetts
Experience with behavioral health integration, alternative payment models, and innovative care delivery strategies
Strong analytical, strategic thinking, and problem-solving skills
Excellent communication skills (verbal, written, electronic)
Proficiency in Microsoft Word, Excel, PowerPoint, Project, Planner, and other MS Office tools
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