The Manager of Network Development & Contracting in Woburn, MA (or working remotely) 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, contracting, and rate negotiations for their assigned territory. Duties include identifying and contracting new/ re-contracting existing providers around Beacon?s need for services, negotiating rates, drafting provider services agreements, overseeing the resolution of language changes and securing executed contracts with providers, developing recruitment plans and ensuring rates negotiated are within established guidelines. Position Responsibilities: Negotiate rates and contract terms with currently contracted providers. In conjunction with internal and external stakeholders, secure executed agreements with identified out of network providers for inclusion in the Beacon Health network. Perform reimbursement analysis on providers that are outside of the targeted rate schedule or performance standards and develop strategies for cost reductions, member needs and increasing quality. Identify opportunities for cost savings and process improvements related to the contracting process. Review and draft suggested language changes, and oversee resolution of all proposed changes to the provider services agreement. Participate in provider meetings, trainings. Ensure that Contract Language is in compliance with plan agreements and within all state and federal regulatory and NCQA standards. Participate in provider network Continuous Quality Improvement activities. Provide general support to all network development activities. Strategize with and other members of the management team and client/plan to ensure access and availability of providers meets current standards Collaborate with other departments to address and resolve operational issues as related to negotiated contract language. Act as network liaison to client health plans with onsite presence as needed. Other duties as assigned and specified by supervisor in line with Department and company needs. Position Requirements: Education : Bachelor?s Degree Relevant Work Experience: MS Office ? 3 years Rate & Contract Language Negotiation ? 3 years Project Management ? 1-2 years Analytics ? 1-2 years TO APPLY Click below on ?Apply for this Position? to create a profile and apply for the position 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. Beacon Health Options is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. Beacon Health Options recruiting team will never request payment, financial or personally identifiable information from you. Protect personal information. The identity saved could be your own.
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.