Director, Provider Relations & Contract Development
Company: Beacon Health Options
Location: Little Rock
Posted on: December 4, 2019
Beacon Health OptionsJob Category: Provider & Network - GeneralReq
#: DIRPR01342Schedule: Full TimeLocation: AR - Little RockAbout the
Beacon Health Options is currently seeking a dynamic Director of
Provider Relations and Contracting to join our team in Little Rock,
AR! The Director of Provider Relations and Contracting is a highly
visible both internally and externally, leader of their assigned
market that is leads a team that is accountable for the 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. In addition, this position supports and executes
provider relations aspects of the provider strategy for existing
business as set forth by Regional Operations and Partnerships
leadership, directs provider relations activities to maintain and
enhance the Regional provider network for existing clients,
navigates Beacon's matrix structure to engage, and coordinates and
supports cross-functional Beacon stakeholders. They are expected to
be a thought leader in network operations, fee schedules, and
- Leads a contracting team that leads the development and
execution of network strategic plans that support are part of the
various components of a winning Network strategic plan that
establishes Beacon Health Options as leader in the behavioral
health space. Is directly responsible for the contract strategic
component that integrates the various other mission critical
components of the overall Network Strategy of their assigned
- Is accountable to lead your department in support internal and
external stakeholders, to successfully secure executed agreements
that enhance access for Beacon Members, improves quality care and
is in-line with the overall success of Beacon for all assigned
books of business in assigned market to include Medicaid,
Commercial, and Medicare books of business.
- Validates for accuracy reimbursement analysis on
providers/facilities as required for contract negotiations or other
performance reports, department reports as they impact their
- Is well versed in all aspect of reimbursement methodologies and
is considered a thought leader to internal departments in Beacon
for DRGs, FFS, RVRBS, APCs, Per Diem, Case Rate and VBP, CPT and
HCPC codes as it relates to contracting system payment
configuration and claims payment.
- Is well versed in Medicaid and Medicare program managed
regulations for assigned market and has a team that is similar
capable and up-to-date on relevant managed care regulations for
- Identifies opportunities for cost savings and process
improvements related to the contracting process.
- Directs provider contracting staff to assure day-to-day
activities are performed effectively and support the assigned
market network strategy, including meeting financial targets.
- Ensures that departments properly reviews, draft and document
suggested language changes, and oversee resolution of all proposed
changes to the provider services agreement, secures appropriate
internal approval on finalized changes, that are in-line with
- Ensures that Contract Language for products in their
region/market is in compliance with plan agreements and within all
state and federal regulatory and NCQA standards and kept
- Prepares reports and analyze data as directed by the Region AVP
of Contracting or other members of the management team in the
- Effectively lead the Provider Relations team as evidenced by
provider, internal customer and client satisfaction, compliance
with internal, client, regulatory and accreditation standards,
successful audits, and employee satisfaction and engagement.
- Direct Provider Relations staff to assure day-to-day activities
are performed effectively and support the Region's network
strategy, including meeting financial targets.
- In collaboration with Network Management Leadership, execute on
a process improvement strategy which identifies provider
satisfaction impacts and root cause of issues to achieve shorter
provider inquiry response times, improved employee engagement, and
higher provider satisfaction.
- Serve as the network escalation point for Regional Leadership
on provider relations issues.
- Support and participate in the Network Management Department's
process improvement and transformational initiatives to drive
completion and successful outcomes.
- Assure the Provider Relations team is accountable to Network
Management Leadership, Corporate Operations, and Regional Teams by
meeting internal and external performance standards and
- Develop strong provider relationships built on trust and
collaboration. Manage and balance Beacon and provider
- Oversee coordination of practitioner and facility orientation
- Collaborate with the Quality and Legal Departments to perform
complaint and grievance resolution and communication.
- Contribute to provider communications such as newsletters,
provider manual, mailings, and training.
- Collaborate with the Network Development team to transition new
business to ongoing operations.
- Meet or exceed administrative budget targets targets.
- Act as liaison and maintain productive working relationships
with all Beacon departments.
- Adheres to all Beacon policies and procedures and standards of
- 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
- Assist team members and offers suggestions to improve
processes, culture, or work environment.
- Performs special projects and other duties as assigned and
- Education: Bachelor's Degree in Business, Finance or Healthcare
- Relevant Work Experience: 5-8 years experience in Provider
Relations, Contracting or similar managed care roles that includes
rate & contract language negotiation and network operations
required with at least 3-5 years of management experience
- Knowledge, Skills, & Abilities:
- In-depth knowledge and experience in provider reimbursement
- Knowledge of managed care contract requirements to include
state and federal regulatory requirements for relevant commercial
products, Medicaid plans and CMS guidelines required
- Travel: up to 20% overnight and local travel required
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. PI115936212
Keywords: Beacon Health Options, Little Rock , Director, Provider Relations & Contract Development, Accounting, Auditing , Little Rock, Arkansas
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