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Manager, Provider Partnerships

Manager, Provider Partnerships

Job Description

WHY BEACON?

Beacon’s objective is to be the single best source of clinical excellence and cost containment for the most complex individuals in any covered population.  In close partnership with health plans, we help bring together the fragmented pieces of healthcare to achieve better results for our members. Much like the uniquely effective programs we have developed for our members, Beacon also strives to offer a uniquely effective employee experience for all. We offer a competitive benefits package that includes: medical, dental, vision, 401K with company match.  We also offer STD, LTD and Life Insurance coverage that is entirely paid for by Beacon.  Employees are also welcome to participate in our Flexible Spending Accounts (Medical and Dependent/Parking and Transit) as well as our Tuition Reimbursement Program.  We truly value our employees and encourage continual development in a diverse and collaborative work environment.  We also have a rewarding companywide employee recognition program that is fueled by employee performance and contributions. Enhance your knowledge and dedication to quality healthcare by fully utilizing your expertise at one of our specialized behavioral health solutions: Beacon in Boston, MA; Autism Services Group in Ewing, NJ; College Health IPA in Cypress, CA; Psychcare, LLC in Miami, FL; and Beacon UK in the United Kingdom, and additional opportunities across the nation.  Apply today and find your potential with Beacon.

Beacon Health Strategies is an EOE.

JOB SUMMARY:

Mission: Build highly collaborative relationships with providers, drive provider performance improvement year-over-year through education and data, and identify top-performing providers for innovative programs/pilots

Outcomes

  1. Generate net promoter score (NPS) from providers of +30% by the end of 2015 (NPS is a tool to measure satisfaction; more about NPS can be found here: http://netpromotersystem.com/about/index.aspx)
  2. Craft strategic plans for 50% of providers in territory by end of 2014 and 100% by April 1, 2015
  3. Identify both top 10 highest performing and top 10 biggest under-performing providers in territory, using provider profiler data, by end of month 3
  4. Improve health outcomes of members by reducing hospital re-admission rate by 25 bps per year and increasing community tenure of members by 10 bps per year, beginning in 2015
  5. Provide quarterly written summary of provider performance and network operational needs, beginning with Q3 2014
  6. Maintain a 3-month response time for 95% of provider queries, as measured from a daily activity log
  7. Beginning in 2015, identify 1 provider candidate each year to join Beacon’s Provider Advisory Council
  8. Identify two “A" players to join Beacon annually

The Manager, Provider Partnerships, is primarily responsible for interfacing with a strategic subset of Beacon’s network of community providers. Beacon is looking for strategically oriented professionals to help lead the next generation of provider engagement, with a focus on leveraging the tremendous amount of data available to providers to help improve the value delivered to Beacon members. The Manager will achieve this by building strategic partnerships and bringing an analytic mindset to discussions with providers.

The Manager will be expected to lead analysis of data sets to be able to identify data outliers and opportunities for improvement for individual providers. The Manager will need to build relationships with internal Beacon teams to be successful in this role, in particular coordinating very closely with the clinical team, to ensure high quality care to members, and with the network operations team, to ensure the network team is up-to-date about details concerning each provider. The Manager will then share this strategic data with providers to help educate the provider about the value that each provider is delivering to Beacon members, with a focus on driving high levels of value for Beacon members.

The Manager will be responsible for bringing innovative thinking into the provider community in the region, by identifying high-performing providers who may be interested in new and innovative payment or program models, and then working with those providers to implement the new concepts.

As part of a national network of Managers, Provider Partnerships, the Manager will be responsible for contributing to the best practices of the entire group and for taking best practices and high-quality program ideas/designs into the Manager’s region to drive high levels of value.

The Manager will report to the Account Management in the region, with dotted line responsibility to the corporate Provider Partnerships department, where centralized training, coaching, and data analysis reside

Job Requirements

PRIMARY RESPONSIBILITIES:
 

  1. Serve as direct contact point for a subset of Beacon providers, generally the largest and/or most important in a specific region, and be the “face” of Beacon for those providers
  2. Serve as a “concierge” for strategic providers as they need help and access to Beacon, including receiving inbound questions from provider, filtering question to proper internal audience at Beacon, and either facilitate or deliver the responses from the Beacon team back to the provider
  3. Serve the same “concierge” role for any direct provider query or request, even for those outside of the strategic designation, to ensure there is “no wrong door” for a provider to access assistance from Beacon
  4. Lead meetings with strategic providers, to include set number of meetings per provider, per year
  5. Analyze strategic provider reports around cost, utilization, and outcomes, and prepare reports to share with providers that detail provider performance over time, highlighting key areas of focus
  6. Maintain accountability for the monitoring and interpretation of provider utilization data, to include overseeing data analysis to understand root cause of any outlier utilization and engaging providers to discuss and help remedy outlier utilization; for clinical issues, surface issues to Beacon’s local or service center clinical teams and participate in helping to address concerns
  7. With Account Managers, craft annual strategic plan for each strategic provider partner with measurable goals for each calendar year
  8. Work with Account Management team to ensure provider activities are in line with Beacon priorities
  9. Liaises with Beacon clinical team to be knowledgeable regarding Beacon UR and care management programs and services, to be able to answer or appropriately triage provider questions
  10. Identifies innovative provider programs and gathers information on program structure, function, efficacy and outcomes to share with Beacon innovation warehouse
  11. Solicits annual feedback from providers regarding Beacon partnership and prepares annual regional report on regional provider perspectives
  12. With Account Managers, shares health plan-specific provider performance to educate health plan clients about provider performance, with a focus on utilization outliers
  13. With Corporate Provider Partnerships department, help identify opportunities for innovative pilot programs, to include program development, implementation, launch, and efficacy and outcomes measurements
  14. Assist with provider orientations and provider training events in the region; trainings and orientations will be led by Beacon’s network operations team
  15. Closely collaborate with Beacon’s network operations team to ensure contracting, credentialing and other network operations are completed within necessary timelines and that there is a fluid bi-directional sharing of information
  16. Provide input into rate increase evaluation process led by network operations
  17. Other duties and projects as assigned and specified by supervisor in line with Department and company needs.

Beacon anticipates the Manager, Provider Partnerships, will spend time each week in four main ways:

  • On-site provider outreach, via scheduled meetings (1-2 days/week)
  • Analyze provider data to determine utilization and outcomes outliers, including root cause analysis for outliers (~1 day/week)
  • Developing strategy for specific provider engagement activities to be executed (1-2 days/week)
  • PowerPoint report generation to prepare for on-site provider outreach meetings (~1 day/week)


DISCLAIMER:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

QUALIFICATIONS:
      

  • Master’s degree in Business Administration, Public Administration, Public Health, or Behavioral Health required. 
  • Independently licensed behavioral health clinicians strongly considered. 
  • Professional demeanor, strong written and oral communication skills needed.
  • 3-5 years of experience in managed care, analytics, and performance improvement and clinical skill required.       
  • Strong execution and follow-up skills, analytic skills, and a proven ability to multi-task are essential.

Job Snapshot

Employment Type Full-Time
Job Type Health Care
Education Graduate Degree
Experience At least 3 year(s)
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel Not Specified
Job ID ZB05-23
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Manager, Provider Partnerships


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