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Contract Development Mgr II
at Beacon Health Options
Woburn, MA

Contract Development Mgr II
at Beacon Health Options
Woburn, MA

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Contacts

Description

Beacon Health Options

Job Category: Provider & Network - Contracting
Req #: CONTR01509
Schedule: Full Time
Location: MA - Woburn


We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a 'world-class' candidate experience from the moment you click 'Apply'! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Contract Development Manager to join our team at our Woburn, MA office. The Contract Development Manager leads all territory network development and contract management activities for a growing and complex managed behavioral health care organization. The position is responsible for network development, recruiting for new business, contracting, and rate negotiations for their assigned territory and or state. Duties include identifying and contracting new/ re-contracting existing providers around Beacon's need for services, negotiating rates, drafting provider services and facility agreements, sending and receiving credentialing applications, overseeing the resolution of language changes and securing executed contracts with providers, developing recruitment plans and reports and ensuring rates negotiated are within established guidelines.

What does a typical day look like?
  • Proactively seek and recruit providers to build provider network through field work recruitment and developing and maintain relationships with providers and facility staff.
  • Interact and recruit providers by conducting periodic in-person visits, calls, and follow up meetings.
  • Negotiates rates and contract terms with currently contracted providers and facilities.
  • In conjunction with internal and external stakeholders, secure executed agreements with identified out of network providers for inclusion in the Beacon Health network.
  • Performs reimbursement analysis on providers/facilities that are outside of the targeted rate schedule or performance standards and develop strategies for cost reductions, member needs and increasing quality.
  • Has a keen understanding of Quest or other Geo Access information to ensure that we are targeting the right areas of need and addressing any gap areas quickly and efficiently.
  • Identifies opportunities for cost savings and process improvements related to the contracting process.
  • Review, draft and document suggested language changes, and oversee resolution of all proposed changes to the provider services agreement.
  • Ensures that Contract Language is in compliance with plan agreements and within all state and federal regulatory and NCQA standards.
  • Gather, review and submit credentialing applications, as required, for network development and management.
  • Provides general support to all network development activities and support Director with implementation requirements.
  • Strategizes with other members of the management team and client/plan to ensure access and availability of providers meets current standards.
  • Collaborates with other departments to address and resolve operational issues as related to negotiated contract language.
  • Prepares reports and analyze data as directed by the Director of Provider Relations or other members of the management team.
  • Adheres to all Beacon policies and procedures and standards of operations.
  • Completes all required and assigned trainings.
  • Attends all mandatory company or department meetings.
  • Reports to each scheduled shift and commence work and perform essential job function at the start of each schedule shift.
  • Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.
  • Acts as a mentor to junior team members by leading by example and guiding with a sense of integrity and team work.
  • Assists management with identifying opportunities for staff improvement, high performing team members, and training needs of team members.
  • Assist team members and offers suggestions to improve processes, culture, or work environment.
  • Performs special projects and other duties as assigned and required.

  • What you Contribute?

    Education: High School diploma or GED required. Bachelor's degree preferred or equivalent experience in health care field.

    Licensure: Valid State Driver's License Required

    Knowledge, Skills & Abilities:
    • At least 3 years' experience rate & contract language negotiation to include facility and higher level of care experience;
    • In-depth knowledge of all facility, and some provider reimbursement methodologies- behavioral health experience a plus.
    • Knowledge of managed care contract requirements to include state and federal regulatory requirements for Medicare and Medicaid plans and CMS guidelines.
    • Strong interpersonal skills and good written and verbal communication skills.
    • Computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint.
    • Ability to travel

    What Makes Us Different?
    • Here, it's not just a job - it's an opportunity to change lives.
    • Our employees are learners, innovators and original thinkers.
    • Our mission and values guide the way we treat our members, providers and each other.

    What We Have to Offer:
    • Healthcare benefits available starting day 1!
    • Health & wellbeing incentives, such as gym membership reimbursement
    • 401K with company match to help reach your future financial goals
    • Generous PTO, because we know life happens outside of work
    • Tuition reimbursement so you can keep reaching your fullest potential

    If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

    Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

    At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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