Managed Care / Payer Contracting Consultant

Human Health Project (HHP) is a holistic health literacy charity. Our mission is to improve the health of the underserved and vulnerable through holistic information, education and advocacy. Our objective is to empower people to manage their own health with improved outcomes and no medical errors. For more information, please visit our website including viewing our "Shared Patient Information" program page which includes 50 pages of reports on both our Migraine and Lupus and feedback received from people who reviewed the reports in the section, "What Our Members are Saying" - https://tinyurl.com/4c5y3mfa and our "Healthcare Access Program" which includes short video courses in our Learning Academy - https://tinyurl.com/4xwdz5wh , Patient Advocacy Workshops in Los Angeles, - https://tinyurl.com/mryave5x and in Northern Ireland - https://tinyurl.com/nhj6kp7p and our Online Peer to Peer Events - https://tinyurl.com/5ddmxuyn

Focus: High-level strategy, identifying rapid-reimbursement pathways (like Community Health Worker or Health Education codes), and evaluating model feasibility within your 12-week roadmap.

Human Health Project (HHP) is a global health literacy nonprofit dedicated to empowering individuals through peer-led information sharing and community support. We are currently on a 12-week roadmap to launch initial services and establish sustainable reimbursement workflows. We are seeking a strategic, senior-level Volunteer Managed Care & Payer Contracting Consultant to guide our market entry.

The Role:

You will serve as our principal strategic advisor for insurance payer alignment. Instead of focusing solely on credentialing paperwork, you will analyze HHP’s peer-led health literacy model, match it to the most viable billing architectures (such as Community Health Worker codes, health education modifiers, or SDOH incentives), and evaluate fast-track contracting opportunities or strategic clinic partnerships.

Key Responsibilities:

• Analyze HHP's service model to identify immediate, "low-hanging fruit" reimbursement opportunities within commercial insurance and Medicaid/Medi-Cal frameworks.
• Formulate HHP’s initial payer positioning strategy, assessing whether to pursue direct enrollment or establish sub-contracting/billing partnerships with existing community clinics.
• Review potential payment models (fee-for-service vs. grant-funded or value-based pilots) to ensure alignment with HHP's long-term sustainability goals.
• Advise executive leadership on structural prerequisites needed to meet managed care organization (MCO) compliance baselines.

Qualifications:

• 5+ years of experience in healthcare administration, managed care contracting, payer relations, or healthcare consulting.
• Deep understanding of health plan structures, provider networks, and medical coding/reimbursement mechanics.
• Experience navigating public health programs (Medicaid/Medi-Cal) and community-benefit contract requirements is highly preferred.
• Ability to dedicate 3–5 hours per week for strategic advisory sessions and reviews during our 12-week launch runway.